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 $467.74 Median $2,238.72 Typical High $5,128.61 | Facility | None | $467.74 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $3,981.07 | Professional | None | $457.09 | $467.74 | $3,981.07 |
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 $407.38 Median $501.19 Typical High $691.83 | Professional | None | $407.38 | $501.19 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,019.95 Typical High $4,365.16 | Facility | None | $501.19 | $3,019.95 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $676.08 | Professional | None | $281.84 | $338.84 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $5.25 Median $457.09 Typical High $676.08 | Professional | None | $5.25 | $457.09 | $676.08 |
Hometown Health Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Hometown Health Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $602.56 | Professional | None | $4.47 | $4.47 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $4,265.80 | Facility | None | $398.11 | $398.11 | $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 $275.42 Median $457.09 Typical High $707.95 | Professional | None | $275.42 | $457.09 | $707.95 |
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 $229.09 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $323.59 |
Where Nevada sits
The same service costs 5.4 times more in Alaska than in New York. 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· 30th of 51
$692
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.