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 $288.40 Median $2,570.40 Typical High $5,011.87 | Facility | None | $288.40 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | None | $263.03 | $295.12 | $323.59 |
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 $275.42 Median $316.23 Typical High $501.19 | Professional | None | $275.42 | $316.23 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $954.99 Typical High $1,348.96 | Facility | None | $616.60 | $954.99 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $489.78 | Professional | None | $245.47 | $316.23 | $489.78 |
Hometown Health Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $602.56 | Professional | None | $199.53 | $323.59 | $602.56 |
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 $1.07 Median $389.05 Typical High $1,380.38 | Professional | None | $1.07 | $389.05 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $4,265.80 | Facility | None | $263.03 | $316.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $489.78 | Professional | None | $208.93 | $302.00 | $489.78 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $501.19 | Professional | None | $208.93 | $316.23 | $501.19 |
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 $131.83 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $131.83 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $52.48 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | 54 · Surgery only | $199.53 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $229.09 |
Where Nevada sits
The same service costs 6.8 times more in Alaska than in Utah. 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· 38th of 51
$324
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.