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 $645.65 Median $2,570.40 Typical High $6,165.95 | Facility | None | $645.65 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | None | $588.84 | $588.84 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,096.48 | Professional | None | $602.56 | $691.83 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,819.70 Typical High $2,511.89 | Facility | None | $616.60 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,023.29 | Professional | None | $512.86 | $645.65 | $1,023.29 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $537.03 Typical High $977.24 | Professional | None | $7.59 | $537.03 | $977.24 |
Hometown Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $851.14 | Professional | None | $5.75 | $5.75 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $4,265.80 | Facility | None | $562.34 | $562.34 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $1,148.15 | Professional | None | $457.09 | $562.34 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,096.48 | Professional | None | $549.54 | $676.08 | $1,096.48 |
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 $288.40 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $446.68 |
Where Nevada sits
The same service costs 7.4 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· 40th of 51
$676
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.