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 $501.19 Median $3,162.28 Typical High $5,011.87 | Facility | None | $501.19 | $3,162.28 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $676.08 | Professional | None | $478.63 | $645.65 | $676.08 |
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 $457.09 Median $549.54 Typical High $1,047.13 | Professional | None | $457.09 | $549.54 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,311.31 Typical High $4,570.88 | Facility | None | $724.44 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $912.01 | Professional | None | $416.87 | $537.03 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $3,801.89 | Professional | None | $446.68 | $707.95 | $3,801.89 |
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 $6.03 Median $616.60 Typical High $4,786.30 | Professional | None | $6.03 | $616.60 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $4,265.80 | Facility | None | $416.87 | $616.60 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $478.63 Median $616.60 Typical High $933.25 | Professional | None | $478.63 | $616.60 | $933.25 |
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 $239.88 Median $323.59 Typical High $338.84 | Professional | 52 · Reduced service | $239.88 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $128.82 Typical High $134.90 | Professional | 53 · Discontinued | $95.50 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $363.08 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $72.44 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $64.57 Typical High $67.61 | Professional | 56 · Pre-op care only | $47.86 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $338.84 | $446.68 | $467.74 |
Where Nevada sits
The same service costs 5.0 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· 42nd of 51
$646
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.