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 $3,019.95 Median $3,019.95 Typical High $3,311.31 | Professional | None | $3,019.95 | $3,019.95 | $3,311.31 |
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 $2,630.27 Median $3,162.28 Typical High $5,888.44 | Professional | None | $2,630.27 | $3,162.28 | $5,888.44 |
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 $2,187.76 Median $2,398.83 Typical High $4,466.84 | Professional | None | $2,187.76 | $2,398.83 | $4,466.84 |
Hometown Health Setting Professional Modifier None Typical Low $38.90 Median $3,090.30 Typical High $4,365.16 | Professional | None | $38.90 | $3,090.30 | $4,365.16 |
Hometown Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $3,715.35 | Professional | None | $33.88 | $33.88 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,454.71 | $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 $2,454.71 Median $3,235.94 Typical High $5,495.41 | Professional | None | $2,454.71 | $3,235.94 | $5,495.41 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,238.72 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,137.96 | $2,137.96 |
Where Nevada sits
The same service costs 6.9 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· 35th of 51
$3,090
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.