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 $1,122.02 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,122.02 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,023.29 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $11,220.18 Typical High $23,988.33 | Facility | None | $4,897.79 | $11,220.18 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,202.26 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $10,715.19 Typical High $14,791.08 | Facility | None | $794.33 | $10,715.19 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,778.28 | Professional | None | $870.96 | $891.25 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $18.20 Median $954.99 Typical High $1,659.59 | Professional | None | $18.20 | $954.99 | $1,659.59 |
Hometown Health Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $1,445.44 | Professional | None | $13.80 | $13.80 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $4,265.80 | Facility | None | $954.99 | $954.99 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,949.84 | Professional | None | $758.58 | $954.99 | $1,949.84 |
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 $891.25 Median $1,071.52 Typical High $1,584.89 | Professional | None | $891.25 | $1,071.52 | $1,584.89 |
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 $512.86 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $794.33 |
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· 36th of 51
$1,202
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.