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 $1,318.26 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,318.26 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,230.27 | $1,778.28 |
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 $1,174.90 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,412.54 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $4,570.88 | Facility | None | $758.58 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,230.27 | $1,905.46 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $1,348.96 Typical High $1,819.70 | Professional | None | $11.48 | $1,348.96 | $1,819.70 |
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 $10.00 Median $10.00 Typical High $1,548.82 | Professional | None | $10.00 | $10.00 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,265.80 | Facility | None | $1,047.13 | $1,047.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $912.01 Median $1,288.25 Typical High $1,862.09 | Professional | None | $912.01 | $1,288.25 | $1,862.09 |
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 $616.60 Median $616.60 Typical High $645.65 | Professional | 52 · Reduced service | $616.60 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $933.25 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $912.01 |
Where Nevada sits
The same service costs 6.8 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· 38th of 51
$1,445
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.