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 $1,548.82 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,548.82 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,412.54 | $1,548.82 |
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 $1,445.44 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,659.59 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,348.96 | Facility | None | $794.33 | $1,000.00 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,047.13 Typical High $2,238.72 | Professional | None | $645.65 | $1,047.13 | $2,238.72 |
Hometown Health Setting Professional Modifier None Typical Low $6.46 Median $1,122.02 Typical High $2,089.30 | Professional | None | $6.46 | $1,122.02 | $2,089.30 |
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 $4.79 Median $4.79 Typical High $1,995.26 | Professional | None | $4.79 | $4.79 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $4,265.80 | Facility | None | $1,318.26 | $1,318.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,318.26 | $2,691.53 |
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 $1,174.90 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,412.54 | $2,089.30 |
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 $707.95 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,071.52 |
Where Nevada sits
The same service costs 17.0 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· 40th of 51
$1,445
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.