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 $1,000.00 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,000.00 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,737.80 | Professional | None | $933.25 | $1,071.52 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,897.79 Typical High $7,079.46 | Facility | None | $794.33 | $4,897.79 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,621.81 | Professional | None | $794.33 | $851.14 | $1,621.81 |
Hometown Health Setting Professional Modifier None Typical Low $13.49 Median $851.14 Typical High $1,479.11 | Professional | None | $13.49 | $851.14 | $1,479.11 |
Hometown Health Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $1,288.25 | Professional | None | $10.00 | $10.00 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $4,265.80 | Facility | None | $851.14 | $851.14 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,737.80 | Professional | None | $691.83 | $851.14 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,548.82 | Professional | None | $831.76 | $1,000.00 | $1,548.82 |
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 $457.09 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $691.83 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $707.95 |
Where Nevada sits
The same service costs 7.9 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· 37th of 51
$1,072
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.