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 $371.54 Median $2,238.72 Typical High $5,011.87 | Facility | None | $371.54 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $616.60 | Professional | None | $338.84 | $562.34 | $616.60 |
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 $346.74 Median $398.11 Typical High $645.65 | Professional | None | $346.74 | $398.11 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,230.27 Typical High $1,778.28 | Facility | None | $501.19 | $1,230.27 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $741.31 | Professional | None | $257.04 | $457.09 | $741.31 |
Hometown Health Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $1,096.48 | Professional | None | $234.42 | $467.74 | $1,096.48 |
Hometown Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $3.80 Median $537.03 Typical High $1,819.70 | Professional | None | $3.80 | $537.03 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $630.96 Typical High $4,265.80 | Facility | None | $354.81 | $630.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $707.95 | Professional | None | $281.84 | $512.86 | $707.95 |
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 $257.04 Median $426.58 Typical High $758.58 | Professional | None | $257.04 | $426.58 | $758.58 |
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 $169.82 Median $223.87 Typical High $288.40 | Professional | 52 · Reduced service | $169.82 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $89.13 Typical High $114.82 | Professional | 53 · Discontinued | $67.61 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $331.13 Typical High $436.52 | Professional | 54 · Surgery only | $251.19 | $331.13 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $67.61 Typical High $87.10 | Professional | 55 · Aftercare only | $50.12 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $44.67 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.88 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $309.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $234.42 | $309.03 | $407.38 |
Where Nevada sits
The same service costs 4.7 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· 42nd of 51
$468
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.