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 $380.19 Median $2,238.72 Typical High $5,011.87 | Facility | None | $380.19 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $489.78 | Professional | None | $346.74 | $446.68 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $676.08 | Professional | None | $354.81 | $407.38 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $2,238.72 | Facility | None | $501.19 | $1,548.82 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $436.52 Typical High $676.08 | Professional | None | $162.18 | $436.52 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $891.25 | Professional | None | $288.40 | $467.74 | $891.25 |
Hometown Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $501.19 Typical High $2,344.23 | Professional | None | $4.79 | $501.19 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $4,265.80 | Facility | None | $331.13 | $478.63 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $676.08 | Professional | None | $269.15 | $416.87 | $676.08 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $676.08 | Professional | None | $288.40 | $457.09 | $676.08 |
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 $173.78 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $173.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $69.18 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $257.04 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $34.67 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $239.88 | $302.00 | $338.84 |
Where Nevada sits
The same service costs 6.0 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· 38th of 51
$447
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.