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 $870.96 Median $4,365.16 Typical High $41,686.94 | Facility | None | $870.96 | $4,365.16 | $41,686.94 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $3,981.07 | Professional | None | $870.96 | $870.96 | $3,981.07 |
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 $776.25 Median $933.25 Typical High $1,698.24 | Professional | None | $776.25 | $933.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $15,848.93 | Facility | None | $562.34 | $912.01 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,348.96 | Professional | None | $691.83 | $741.31 | $1,348.96 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $891.25 Typical High $1,318.26 | Professional | None | $11.48 | $891.25 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $1,148.15 | Professional | None | $10.00 | $10.00 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $4,265.80 | Facility | None | $758.58 | $758.58 | $4,265.80 |
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 $562.34 Median $954.99 Typical High $1,380.38 | Professional | None | $562.34 | $954.99 | $1,380.38 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Nevada sits
The same service costs 4.6 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· 36th of 51
$1,023
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.