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 $3,019.95 Median $3,019.95 Typical High $3,311.31 | Facility | None | $3,019.95 | $3,019.95 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,311.31 | Professional | None | $3,019.95 | $3,019.95 | $3,311.31 |
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 $3,090.30 Median $3,548.13 Typical High $5,011.87 | Professional | None | $3,090.30 | $3,548.13 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,621.81 Typical High $2,238.72 | Facility | None | $691.83 | $1,621.81 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $3,311.31 Typical High $6,606.93 | Professional | None | $724.44 | $3,311.31 | $6,606.93 |
Hometown Health Setting Professional Modifier None Typical Low $6.46 Median $8.32 Typical High $1,513.56 | Professional | None | $6.46 | $8.32 | $1,513.56 |
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 $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,128.61 | Professional | None | $5,011.87 | $5,011.87 | $5,128.61 |
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 $602.56 Median $2,137.96 Typical High $4,168.69 | Professional | None | $602.56 | $2,137.96 | $4,168.69 |
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 $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | 53 · Discontinued | $602.56 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,290.87 |
Where Nevada sits
The same service costs 21.4 times more in Alaska than in Kentucky. 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· 32nd of 51
$3,020
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.