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 $524.81 Median $1,698.24 Typical High $4,466.84 | Facility | None | $524.81 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | None | $478.63 | $478.63 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $912.01 | Professional | None | $489.78 | $562.34 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $1,318.26 | Facility | None | $398.11 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $724.44 | Professional | None | $389.05 | $398.11 | $724.44 |
Hometown Health Setting Professional Modifier None Typical Low $4.07 Median $436.52 Typical High $812.83 | Professional | None | $4.07 | $436.52 | $812.83 |
Hometown Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $707.95 | Professional | None | $3.09 | $3.09 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $4,265.80 | Facility | None | $478.63 | $478.63 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $954.99 | Professional | None | $380.19 | $478.63 | $954.99 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $741.31 | Professional | None | $398.11 | $489.78 | $741.31 |
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 $239.88 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $371.54 |
Where Nevada sits
The same service costs 7.6 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
$537
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.