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 $1,071.52 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,071.52 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | None | $977.24 | $977.24 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $11,220.18 | Facility | None | $4,897.79 | $8,128.31 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,148.15 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $7,079.46 Typical High $10,232.93 | Facility | None | $794.33 | $7,079.46 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,659.59 | Professional | None | $831.76 | $831.76 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $15.85 Median $891.25 Typical High $1,584.89 | Professional | None | $15.85 | $891.25 | $1,584.89 |
Hometown Health Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $1,380.38 | Professional | None | $12.02 | $12.02 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,265.80 | Facility | None | $912.01 | $912.01 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,862.09 | Professional | None | $724.44 | $912.01 | $1,862.09 |
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 $870.96 Median $1,047.13 Typical High $1,548.82 | Professional | None | $870.96 | $1,047.13 | $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 $489.78 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $489.78 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $724.44 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $741.31 |
Where Nevada sits
The same service costs 8.5 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
$1,122
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.