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 $10,715.19 | Facility | None | $1,513.56 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $14,454.40 | Facility | None | $2,951.21 | $5,623.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,698.24 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,288.25 | $2,344.23 |
Hometown Health Setting Professional Modifier None Typical Low $19.50 Median $1,445.44 Typical High $2,089.30 | Professional | None | $19.50 | $1,445.44 | $2,089.30 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $1,819.70 | Professional | None | $16.98 | $16.98 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,265.80 | Facility | None | $1,202.26 | $1,202.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
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 $758.58 Median $758.58 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,122.02 |
Where Nevada sits
The same service costs 7.8 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· 37th 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.