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 $2,344.23 Median $2,398.83 Typical High $2,630.27 | Professional | None | $2,344.23 | $2,398.83 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $6,760.83 Typical High $9,332.54 | Facility | None | $3,801.89 | $6,760.83 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $4,897.79 | Professional | None | $2,041.74 | $2,511.89 | $4,897.79 |
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 $1,905.46 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,905.46 | $1,995.26 | $3,630.78 |
Hometown Health Setting Professional Modifier None Typical Low $33.11 Median $2,454.71 Typical High $3,311.31 | Professional | None | $33.11 | $2,454.71 | $3,311.31 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $2,884.03 | Professional | None | $28.18 | $28.18 | $2,884.03 |
Select Health Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $4,265.80 | Facility | None | $1,905.46 | $1,905.46 | $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 $2,041.74 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,041.74 | $2,630.27 | $4,265.80 |
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 $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,174.90 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Where Nevada sits
The same service costs 5.4 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· 34th of 51
$2,512
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.