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 $1,230.27 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,230.27 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,122.02 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,318.26 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $5,370.32 Typical High $7,762.47 | Facility | None | $724.44 | $5,370.32 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,122.02 | $1,995.26 |
Hometown Health Setting Professional Modifier None Typical Low $15.85 Median $1,047.13 Typical High $1,778.28 | Professional | None | $15.85 | $1,047.13 | $1,778.28 |
Hometown Health Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
Hometown Health Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $1,584.89 | Professional | None | $11.75 | $11.75 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,265.80 | Facility | None | $1,047.13 | $1,047.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,137.96 | Professional | None | $831.76 | $1,047.13 | $2,137.96 |
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 $1,071.52 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,258.93 | $1,949.84 |
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 $562.34 Median $562.34 Typical High $616.60 | Professional | 52 · Reduced service | $562.34 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $870.96 |
Where Nevada sits
The same service costs 8.3 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
$1,318
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.