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 $1,071.52 Typical High $1,380.38 | Facility | None | $977.24 | $1,071.52 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,380.38 | Professional | None | $977.24 | $1,258.93 | $1,380.38 |
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 $1,000.00 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,148.15 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $831.76 Typical High $1,122.02 | Facility | None | $676.08 | $831.76 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,089.30 | Professional | None | $977.24 | $1,258.93 | $2,089.30 |
Hometown Health Setting Professional Modifier None Typical Low $33.88 Median $1,096.48 Typical High $1,995.26 | Professional | None | $33.88 | $1,096.48 | $1,995.26 |
Hometown Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Hometown Health Setting Professional Modifier None Typical Low $20.42 Median $1,122.02 Typical High $2,089.30 | Professional | None | $20.42 | $1,122.02 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $4,265.80 | Facility | None | $912.01 | $1,412.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,862.09 | Professional | None | $724.44 | $1,202.26 | $1,862.09 |
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 $1,071.52 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,513.56 | $2,137.96 |
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 $489.78 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $194.98 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $144.54 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $676.08 | $891.25 | $977.24 |
Where Nevada sits
The same service costs 5.0 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· 43rd of 51
$1,259
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.