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 $977.24 Median $2,570.40 Typical High $6,165.95 | Facility | None | $977.24 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | None | $891.25 | $891.25 | $977.24 |
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 $912.01 Median $1,047.13 Typical High $1,698.24 | Professional | None | $912.01 | $1,047.13 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $7,079.46 Typical High $10,232.93 | Facility | None | $616.60 | $7,079.46 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,479.11 | Professional | None | $776.25 | $891.25 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $812.83 Typical High $1,412.54 | Professional | None | $11.48 | $812.83 | $1,412.54 |
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 $8.71 Median $8.71 Typical High $1,258.93 | Professional | None | $8.71 | $8.71 | $1,258.93 |
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 $676.08 Median $831.76 Typical High $1,698.24 | Professional | None | $676.08 | $831.76 | $1,698.24 |
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 $851.14 Median $1,000.00 Typical High $1,584.89 | Professional | None | $851.14 | $1,000.00 | $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 $446.68 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $691.83 |
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· 38th 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.