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 $1,548.82 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,548.82 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,548.82 | $1,548.82 | $1,737.80 |
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 $1,348.96 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,659.59 | $3,019.95 |
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 $1,258.93 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,412.54 | $2,344.23 |
Hometown Health Setting Professional Modifier None Typical Low $25.70 Median $1,584.89 Typical High $2,238.72 | Professional | None | $25.70 | $1,584.89 | $2,238.72 |
Hometown Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $1,949.84 | Professional | None | $22.39 | $22.39 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,265.80 | Facility | None | $1,288.25 | $1,288.25 | $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 $1,348.96 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,862.09 | $2,818.38 |
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 $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,096.48 |
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· 35th of 51
$1,738
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.