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 $776.25 Median $4,897.79 Typical High $8,128.31 | Facility | None | $776.25 | $4,897.79 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | None | $707.95 | $707.95 | $776.25 |
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 $724.44 Median $831.76 Typical High $1,348.96 | Professional | None | $724.44 | $831.76 | $1,348.96 |
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 $588.84 Median $588.84 Typical High $1,096.48 | Professional | None | $588.84 | $588.84 | $1,096.48 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $602.56 Typical High $1,122.02 | Professional | None | $10.47 | $602.56 | $1,122.02 |
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 $7.76 Median $7.76 Typical High $1,000.00 | Professional | None | $7.76 | $7.76 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $4,265.80 | Facility | None | $660.69 | $660.69 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,348.96 | Professional | None | $524.81 | $660.69 | $1,348.96 |
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 $616.60 Median $758.58 Typical High $1,122.02 | Professional | None | $616.60 | $758.58 | $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 $354.81 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $141.25 | $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 $117.49 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $77.62 |
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 8.5 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
$832
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.