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 $794.33 Median $4,897.79 Typical High $8,128.31 | Facility | None | $794.33 | $4,897.79 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | None | $724.44 | $724.44 | $794.33 |
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 $741.31 Median $851.14 Typical High $1,318.26 | Professional | None | $741.31 | $851.14 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,311.31 Typical High $4,570.88 | Facility | None | $1,148.15 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $1,071.52 | Professional | None | $501.19 | $537.03 | $1,071.52 |
Hometown Health Setting Professional Modifier None Typical Low $15.49 Median $630.96 Typical High $1,174.90 | Professional | None | $15.49 | $630.96 | $1,174.90 |
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 $11.75 Median $11.75 Typical High $1,047.13 | Professional | None | $11.75 | $11.75 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $4,265.80 | Facility | None | $691.83 | $691.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,380.38 | Professional | None | $549.54 | $691.83 | $1,380.38 |
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 $549.54 Median $741.31 Typical High $1,122.02 | Professional | None | $549.54 | $741.31 | $1,122.02 |
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 $363.08 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $549.54 |
Where Nevada sits
The same service costs 17.4 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· 32nd of 51
$851
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.