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 $239.88 Median $2,238.72 Typical High $5,011.87 | Facility | None | $239.88 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $380.19 | Professional | None | $218.78 | $346.74 | $380.19 |
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 $229.09 Median $263.03 Typical High $426.58 | Professional | None | $229.09 | $263.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,737.80 Typical High $2,454.71 | Facility | None | $501.19 | $1,737.80 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $478.63 | Professional | None | $199.53 | $316.23 | $478.63 |
Hometown Health Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $676.08 | Professional | None | $162.18 | $302.00 | $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 $2.00 Median $331.13 Typical High $2,570.40 | Professional | None | $2.00 | $331.13 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $4,265.80 | Facility | None | $218.78 | $354.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $446.68 | Professional | None | $177.83 | $281.84 | $446.68 |
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 $338.84 Typical High $512.86 | Professional | None | $208.93 | $338.84 | $512.86 |
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 $109.65 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $109.65 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $43.65 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $165.96 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $33.11 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $21.88 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $229.09 | $263.03 |
Where Nevada sits
The same service costs 5.5 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· 44th 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.