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 $407.38 Median $2,570.40 Typical High $6,165.95 | Facility | None | $407.38 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | None | $371.54 | $371.54 | $407.38 |
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 $380.19 Median $436.52 Typical High $707.95 | Professional | None | $380.19 | $436.52 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,890.45 Typical High $5,495.41 | Facility | None | $616.60 | $3,890.45 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $676.08 | Professional | None | $323.59 | $426.58 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $5.01 Median $363.08 Typical High $645.65 | Professional | None | $5.01 | $363.08 | $645.65 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $575.44 | Professional | None | $3.72 | $3.72 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $4,265.80 | Facility | None | $380.19 | $380.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $758.58 | Professional | None | $302.00 | $380.19 | $758.58 |
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 $263.03 Median $398.11 Typical High $707.95 | Professional | None | $263.03 | $398.11 | $707.95 |
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 $186.21 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $281.84 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $288.40 |
Where Nevada sits
The same service costs 7.2 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· 37th 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.