How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $977.24 Median $3,162.28 Typical High $7,244.36 | Facility | None | $977.24 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $3,467.37 | Professional | None | $870.96 | $933.25 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,202.26 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $2,951.21 | Facility | None | $724.44 | $2,137.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,479.11 | Professional | None | $707.95 | $891.25 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $7.08 Median $1,096.48 Typical High $1,445.44 | Professional | None | $7.08 | $1,096.48 | $1,445.44 |
Hometown Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $1,348.96 | Professional | None | $6.03 | $6.03 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,265.80 | Facility | None | $912.01 | $912.01 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,513.56 | Professional | None | $812.83 | $1,000.00 | $1,513.56 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $691.83 |
Where Nevada sits
The same service costs 8.3 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Nevada· 28th of 51
$1,202
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.