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 $954.99 Median $3,981.07 Typical High $8,128.31 | Facility | None | $954.99 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $954.99 | Professional | None | $870.96 | $870.96 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,715.19 Typical High $23,988.33 | Facility | None | $4,570.88 | $10,715.19 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,659.59 | Professional | None | $891.25 | $1,023.29 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,495.41 Typical High $7,762.47 | Facility | None | $794.33 | $5,495.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,548.82 | Professional | None | $758.58 | $758.58 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $17.78 Median $812.83 Typical High $1,412.54 | Professional | None | $17.78 | $812.83 | $1,412.54 |
Hometown Health Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $1,230.27 | Professional | None | $13.18 | $13.18 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $4,265.80 | Facility | None | $831.76 | $831.76 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,659.59 | Professional | None | $660.69 | $831.76 | $1,659.59 |
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 $776.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $776.25 | $1,023.29 | $1,412.54 |
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 $436.52 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $676.08 |
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
$1,023
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.