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 $1,202.26 Median $2,238.72 Typical High $5,128.61 | Facility | None | $1,202.26 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,174.90 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,380.38 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $4,570.88 | Facility | None | $616.60 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,819.70 | Professional | None | $977.24 | $1,023.29 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $1,000.00 Typical High $1,698.24 | Professional | None | $11.22 | $1,000.00 | $1,698.24 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $1,513.56 | Professional | None | $8.32 | $8.32 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,000.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $2,041.74 | Professional | None | $812.83 | $1,000.00 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | None | $851.14 | $1,202.26 | $1,778.28 |
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 $588.84 Median $588.84 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $234.42 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $891.25 |
Where Nevada sits
The same service costs 16.6 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· 34th of 51
$1,349
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.