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 $1,071.52 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,071.52 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,071.52 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,454.71 | Professional | None | $933.25 | $1,148.15 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,454.71 | Facility | None | $691.83 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,778.28 | Professional | None | $645.65 | $912.01 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $14.13 Median $1,148.15 Typical High $1,479.11 | Professional | None | $14.13 | $1,148.15 | $1,479.11 |
Hometown Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $1,288.25 | Professional | None | $12.02 | $12.02 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $4,265.80 | Facility | None | $851.14 | $851.14 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,659.59 | Professional | None | $851.14 | $1,148.15 | $1,659.59 |
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 $537.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Nevada sits
The same service costs 4.6 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· 32nd of 51
$1,479
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.