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 $1,348.96 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,348.96 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,230.27 | $1,230.27 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $11,220.18 Typical High $23,988.33 | Facility | None | $4,897.79 | $11,220.18 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,445.44 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $10,471.29 Typical High $14,791.08 | Facility | None | $724.44 | $10,471.29 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,862.09 | Professional | None | $933.25 | $1,047.13 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $23.99 Median $1,122.02 Typical High $1,995.26 | Professional | None | $23.99 | $1,122.02 | $1,995.26 |
Hometown Health Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $1,737.80 | Professional | None | $18.20 | $18.20 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $4,265.80 | Facility | None | $1,148.15 | $1,148.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,344.23 | Professional | None | $912.01 | $1,148.15 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $11,481.54 | Facility | None | $1,905.46 | $3,090.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,258.93 | $1,905.46 |
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 $602.56 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $933.25 |
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· 36th of 51
$1,413
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.