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 $575.44 Median $2,570.40 Typical High $6,165.95 | Facility | None | $575.44 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | None | $524.81 | $524.81 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $1,000.00 | Professional | None | $537.03 | $616.60 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $512.86 Typical High $741.31 | Facility | None | $407.38 | $512.86 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $812.83 | Professional | None | $398.11 | $436.52 | $812.83 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $446.68 Typical High $794.33 | Professional | None | $7.59 | $446.68 | $794.33 |
Hometown Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $758.58 | Professional | None | $5.62 | $5.62 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $4,265.80 | Facility | None | $512.86 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $1,023.29 | Professional | None | $407.38 | $512.86 | $1,023.29 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $831.76 | Professional | None | $446.68 | $549.54 | $831.76 |
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 $263.03 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $407.38 |
Where Nevada sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 37th of 51
$575
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.