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 $1,258.93 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,258.93 | $1,380.38 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,584.89 | $1,737.80 |
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 $1,288.25 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,513.56 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,288.25 | Facility | None | $691.83 | $933.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,548.82 | $2,630.27 |
Hometown Health Setting Professional Modifier None Typical Low $45.71 Median $1,380.38 Typical High $2,454.71 | Professional | None | $45.71 | $1,380.38 | $2,454.71 |
Hometown Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Hometown Health Setting Professional Modifier None Typical Low $27.54 Median $1,288.25 Typical High $2,570.40 | Professional | None | $27.54 | $1,288.25 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $4,265.80 | Facility | None | $1,148.15 | $1,698.24 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,344.23 | Professional | None | $912.01 | $1,513.56 | $2,344.23 |
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 $1,380.38 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,905.46 | $2,754.23 |
5 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 $630.96 Median $794.33 Typical High $851.14 | Professional | 52 · Reduced service | $630.96 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $316.23 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $257.04 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $158.49 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,096.48 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $891.25 | $1,096.48 | $1,202.26 |
Where Nevada sits
The same service costs 5.1 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· 42nd of 51
$1,585
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.