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 $2,137.96 Median $3,981.07 Typical High $10,715.19 | Facility | None | $2,137.96 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,290.87 | Professional | None | $2,137.96 | $2,137.96 | $2,290.87 |
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 $1,862.09 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,238.72 | $4,073.80 |
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 $1,621.81 Median $1,698.24 Typical High $3,467.37 | Professional | None | $1,621.81 | $1,698.24 | $3,467.37 |
Hometown Health Setting Professional Modifier None Typical Low $26.30 Median $2,187.76 Typical High $2,951.21 | Professional | None | $26.30 | $2,187.76 | $2,951.21 |
Hometown Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $2,511.89 | Professional | None | $22.91 | $22.91 | $2,511.89 |
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 $1,949.84 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,238.72 | $3,311.31 |
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,584.89 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $316.23 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,513.56 | $1,513.56 |
Where Nevada sits
The same service costs 5.1 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
$2,239
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.