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 $1,047.13 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,047.13 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | None | $954.99 | $954.99 | $1,047.13 |
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 $1,000.00 Median $1,148.15 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,148.15 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,311.31 Typical High $4,570.88 | Facility | None | $794.33 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,698.24 | Professional | None | $831.76 | $831.76 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $22.39 Median $912.01 Typical High $1,584.89 | Professional | None | $22.39 | $912.01 | $1,584.89 |
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 $16.98 Median $16.98 Typical High $1,380.38 | Professional | None | $16.98 | $16.98 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,265.80 | Facility | None | $912.01 | $912.01 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,862.09 | Professional | None | $724.44 | $912.01 | $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 $870.96 Median $1,047.13 Typical High $1,584.89 | Professional | None | $870.96 | $1,047.13 | $1,584.89 |
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 $478.63 Median $478.63 Typical High $524.81 | Professional | 52 · Reduced service | $478.63 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | 53 · Discontinued | $190.55 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $724.44 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $741.31 |
Where Nevada sits
The same service costs 21.4 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· 38th of 51
$1,122
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.