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 $2,238.72 Median $2,238.72 Typical High $2,454.71 | Professional | None | $2,238.72 | $2,238.72 | $2,454.71 |
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 $1,949.84 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,344.23 | $4,365.16 |
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 $1,698.24 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,089.30 | $3,467.37 |
Hometown Health Setting Professional Modifier None Typical Low $34.67 Median $2,238.72 Typical High $3,162.28 | Professional | None | $34.67 | $2,238.72 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $2,691.53 | Professional | None | $29.51 | $29.51 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,265.80 | Facility | None | $1,819.70 | $1,819.70 | $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 $1,995.26 Median $2,691.53 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,691.53 | $4,073.80 |
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,659.59 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,584.89 | $1,584.89 |
Where Nevada sits
The same service costs 5.8 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· 33rd of 51
$2,455
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.