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 $1,380.38 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,380.38 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,258.93 | $1,380.38 |
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 $1,318.26 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,513.56 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,168.69 Typical High $5,754.40 | Facility | None | $741.31 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,238.72 | Professional | None | $954.99 | $1,174.90 | $2,238.72 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $1,202.26 Typical High $2,089.30 | Professional | None | $19.05 | $1,202.26 | $2,089.30 |
Hometown Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Hometown Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $1,819.70 | Professional | None | $14.45 | $14.45 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,265.80 | Facility | None | $1,202.26 | $1,202.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,454.71 | Professional | None | $954.99 | $1,202.26 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,621.81 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,380.38 | $2,089.30 |
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 $630.96 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $977.24 |
Where Nevada sits
The same service costs 18.6 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
$1,514
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.