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 $1,096.48 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,096.48 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,122.02 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,290.87 | Professional | None | $954.99 | $1,174.90 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,311.31 Typical High $4,786.30 | Facility | None | $691.83 | $3,311.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,862.09 | Professional | None | $724.44 | $891.25 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $17.38 Median $1,148.15 Typical High $1,548.82 | Professional | None | $17.38 | $1,148.15 | $1,548.82 |
Hometown Health Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $1,318.26 | Professional | None | $15.14 | $15.14 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $4,265.80 | Facility | None | $870.96 | $870.96 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,819.70 | Professional | None | $851.14 | $1,258.93 | $1,819.70 |
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 $549.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Nevada sits
The same service costs 5.0 times more in Wisconsin 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· 23rd of 51
$1,660
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.