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 $1,348.96 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,348.96 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,230.27 | $1,230.27 | $1,348.96 |
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 $1,258.93 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,445.44 | $2,238.72 |
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 $1,023.29 Typical High $1,905.46 | Professional | None | $954.99 | $1,023.29 | $1,905.46 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $1,122.02 Typical High $1,949.84 | Professional | None | $19.05 | $1,122.02 | $1,949.84 |
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 $1,698.24 | Professional | None | $14.45 | $14.45 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,265.80 | Facility | None | $1,122.02 | $1,122.02 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,290.87 | Professional | None | $891.25 | $1,122.02 | $2,290.87 |
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 $1,023.29 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,258.93 | $1,819.70 |
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 $616.60 Median $616.60 Typical High $676.08 | Professional | 52 · Reduced service | $616.60 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $954.99 |
Where Nevada sits
The same service costs 17.8 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· 35th of 51
$1,445
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.