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 $1,513.56 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,513.56 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,445.44 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,621.81 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,311.31 Typical High $4,570.88 | Facility | None | $794.33 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,995.26 | Professional | None | $954.99 | $954.99 | $1,995.26 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $1,258.93 Typical High $2,137.96 | Professional | None | $10.00 | $1,258.93 | $2,137.96 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $1,905.46 | Professional | None | $8.71 | $8.71 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,265.80 | Facility | None | $1,288.25 | $1,288.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,318.26 Typical High $2,137.96 | Professional | None | $794.33 | $1,318.26 | $2,137.96 |
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 $724.44 Median $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,047.13 |
Where Nevada sits
The same service costs 5.9 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· 36th of 51
$1,622
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.