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 $1,621.81 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,621.81 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,659.59 | $1,819.70 |
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 $1,445.44 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,737.80 | $3,162.28 |
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 $1,288.25 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,445.44 | $2,454.71 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $1,659.59 Typical High $2,398.83 | Professional | None | $28.18 | $1,659.59 | $2,398.83 |
Hometown Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $2,041.74 | Professional | None | $23.99 | $23.99 | $2,041.74 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,265.80 | Facility | None | $1,348.96 | $1,348.96 | $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 $1,412.54 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,905.46 | $3,019.95 |
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 $812.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $323.59 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Nevada sits
The same service costs 5.9 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
$1,778
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.