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 $1,071.52 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,365.16 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | None | $1,071.52 | $1,071.52 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,258.93 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,897.79 Typical High $7,079.46 | Facility | None | $691.83 | $4,897.79 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,621.81 | Professional | None | $851.14 | $891.25 | $1,621.81 |
Hometown Health Setting Professional Modifier None Typical Low $12.59 Median $977.24 Typical High $1,698.24 | Professional | None | $12.59 | $977.24 | $1,698.24 |
Hometown Health Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $1,513.56 | Professional | None | $9.33 | $9.33 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,000.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $2,041.74 | Professional | None | $812.83 | $1,000.00 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $891.25 | $1,071.52 | $1,513.56 |
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 $537.03 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $213.80 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $794.33 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $812.83 |
Where Nevada sits
The same service costs 13.8 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· 35th of 51
$1,202
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.