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 $1,995.26 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,995.26 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,995.26 | $2,041.74 | $2,238.72 |
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 $1,778.28 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,778.28 | $2,137.96 | $4,168.69 |
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 $1,584.89 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,819.70 | $3,090.30 |
Hometown Health Setting Professional Modifier None Typical Low $32.36 Median $2,041.74 Typical High $2,884.03 | Professional | None | $32.36 | $2,041.74 | $2,884.03 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $2,454.71 | Professional | None | $28.18 | $28.18 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $4,265.80 | Facility | None | $1,659.59 | $1,659.59 | $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 $1,737.80 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,454.71 | $3,715.35 |
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 $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Nevada sits
The same service costs 5.6 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
$2,138
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.