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 $2,238.72 Median $3,981.07 Typical High $10,715.19 | Facility | None | $2,238.72 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,981.07 | Professional | None | $3,630.78 | $3,630.78 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $11,220.18 | Facility | None | $4,897.79 | $8,128.31 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,801.89 Typical High $6,918.31 | Professional | None | $3,162.28 | $3,801.89 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $13,182.57 Typical High $14,791.08 | Facility | None | $660.69 | $13,182.57 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $5,370.32 | Professional | None | $2,137.96 | $2,818.38 | $5,370.32 |
Hometown Health Setting Professional Modifier None Typical Low $35.48 Median $3,630.78 Typical High $5,128.61 | Professional | None | $35.48 | $3,630.78 | $5,128.61 |
Hometown Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $4,365.16 | Professional | None | $30.90 | $30.90 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,265.80 | Facility | None | $2,951.21 | $2,951.21 | $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 $2,818.38 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,818.38 | $3,801.89 | $5,623.41 |
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 $1,778.28 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,778.28 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,511.89 |
Where Nevada sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 35th of 51
$3,631
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.