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 $676.08 Median $3,981.07 Typical High $10,715.19 | Facility | None | $676.08 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | None | $676.08 | $676.08 | $758.58 |
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 $691.83 Median $794.33 Typical High $1,288.25 | Professional | None | $691.83 | $794.33 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $5,495.41 | Facility | None | $741.31 | $4,073.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,122.02 | Professional | None | $588.84 | $724.44 | $1,122.02 |
Hometown Health Setting Professional Modifier None Typical Low $6.46 Median $630.96 Typical High $1,096.48 | Professional | None | $6.46 | $630.96 | $1,096.48 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $977.24 | Professional | None | $4.79 | $4.79 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $4,265.80 | Facility | None | $645.65 | $645.65 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,318.26 | Professional | None | $524.81 | $645.65 | $1,318.26 |
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 $616.60 Median $741.31 Typical High $1,202.26 | Professional | None | $616.60 | $741.31 | $1,202.26 |
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 $338.84 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $338.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $524.81 |
Where Nevada sits
The same service costs 8.7 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
$794
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.