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 $436.52 Median $1,698.24 Typical High $4,466.84 | Facility | None | $436.52 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | None | $398.11 | $398.11 | $436.52 |
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 $407.38 Median $467.74 Typical High $741.31 | Professional | None | $407.38 | $467.74 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,698.24 Typical High $2,454.71 | Facility | None | $398.11 | $1,698.24 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $588.84 | Professional | None | $257.04 | $331.13 | $588.84 |
Hometown Health Setting Professional Modifier None Typical Low $2.88 Median $354.81 Typical High $676.08 | Professional | None | $2.88 | $354.81 | $676.08 |
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 $2.14 Median $2.14 Typical High $602.56 | Professional | None | $2.14 | $2.14 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $4,265.80 | Facility | None | $398.11 | $398.11 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $794.33 | Professional | None | $316.23 | $398.11 | $794.33 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $223.87 Median $407.38 Typical High $616.60 | Professional | None | $223.87 | $407.38 | $616.60 |
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 $199.53 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $295.12 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $309.03 |
Where Nevada sits
The same service costs 8.1 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
$437
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.