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 $2,238.72 Typical High $5,128.61 | Facility | None | $676.08 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | None | $616.60 | $616.60 | $676.08 |
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 $630.96 Median $724.44 Typical High $1,148.15 | Professional | None | $630.96 | $724.44 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,318.26 | Facility | None | $501.19 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $933.25 | Professional | None | $524.81 | $537.03 | $933.25 |
Hometown Health Setting Professional Modifier None Typical Low $7.94 Median $524.81 Typical High $1,000.00 | Professional | None | $7.94 | $524.81 | $1,000.00 |
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 $6.03 Median $6.03 Typical High $891.25 | Professional | None | $6.03 | $6.03 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $4,265.80 | Facility | None | $588.84 | $588.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $1,202.26 | Professional | None | $478.63 | $588.84 | $1,202.26 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $954.99 | Professional | None | $398.11 | $562.34 | $954.99 |
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 $302.00 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $457.09 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $467.74 |
Where Nevada sits
The same service costs 7.4 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· 39th of 51
$661
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.