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 $676.08 Median $2,238.72 Typical High $5,011.87 | Facility | None | $676.08 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $741.31 | Professional | None | $562.34 | $676.08 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,096.48 | Professional | None | $588.84 | $676.08 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $1,000.00 | Facility | None | $501.19 | $724.44 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $616.60 Typical High $1,000.00 | Professional | None | $269.15 | $616.60 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,071.52 | Professional | None | $436.52 | $676.08 | $1,071.52 |
Hometown Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $7.76 Median $831.76 Typical High $1,071.52 | Professional | None | $7.76 | $831.76 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $707.95 Typical High $4,265.80 | Facility | None | $562.34 | $707.95 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,096.48 | Professional | None | $446.68 | $645.65 | $1,096.48 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $977.24 | Professional | None | $426.58 | $616.60 | $977.24 |
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 $281.84 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $524.81 |
Where Nevada sits
The same service costs 5.6 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· 35th of 51
$676
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.