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 $1,202.26 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,202.26 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,096.48 | $1,202.26 |
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 $1,122.02 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,288.25 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $3,311.31 | Facility | None | $724.44 | $2,398.83 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $933.25 | $1,096.48 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $1,000.00 Typical High $1,698.24 | Professional | None | $15.14 | $1,000.00 | $1,698.24 |
Hometown Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $1,513.56 | Professional | None | $11.48 | $11.48 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,000.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $2,041.74 | Professional | None | $812.83 | $1,000.00 | $2,041.74 |
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 $1,047.13 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,174.90 | $1,862.09 |
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 $549.54 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $831.76 |
Where Nevada sits
The same service costs 19.5 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· 36th of 51
$1,259
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.