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 $691.83 Median $3,981.07 Typical High $10,715.19 | Facility | None | $691.83 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | None | $691.83 | $691.83 | $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 $707.95 Median $812.83 Typical High $1,288.25 | Professional | None | $707.95 | $812.83 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $2,511.89 | Facility | None | $691.83 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $1,047.13 | Professional | None | $524.81 | $562.34 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $6.76 Median $616.60 Typical High $1,148.15 | Professional | None | $6.76 | $616.60 | $1,148.15 |
Hometown Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $1,000.00 | Professional | None | $5.01 | $5.01 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $4,265.80 | Facility | None | $676.08 | $676.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,348.96 | Professional | None | $537.03 | $676.08 | $1,348.96 |
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 $588.84 Median $707.95 Typical High $1,023.29 | Professional | None | $588.84 | $707.95 | $1,023.29 |
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 $346.74 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $346.74 | $380.19 |
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 $524.81 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $537.03 |
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· 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.