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 $436.52 Median $2,570.40 Typical High $5,011.87 | Facility | None | $436.52 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,318.26 Typical High $1,862.09 | Professional | None | $426.58 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $6,760.83 Typical High $12,589.25 | Facility | None | $3,235.94 | $6,760.83 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $1,230.27 Typical High $2,137.96 | Professional | None | $398.11 | $1,230.27 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,778.28 Typical High $2,454.71 | Facility | None | $616.60 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $1,122.02 Typical High $2,089.30 | Professional | None | $302.00 | $1,122.02 | $2,089.30 |
Hometown Health Setting Professional Modifier None Typical Low $363.08 Median $1,513.56 Typical High $2,344.23 | Professional | None | $363.08 | $1,513.56 | $2,344.23 |
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 $2.04 Median $537.03 Typical High $2,570.40 | Professional | None | $2.04 | $537.03 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $1,348.96 Typical High $4,265.80 | Facility | None | $354.81 | $1,348.96 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,047.13 Typical High $2,041.74 | Professional | None | $398.11 | $1,047.13 | $2,041.74 |
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 $213.80 Median $245.47 Typical High $707.95 | Professional | 52 · Reduced service | $213.80 | $245.47 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $281.84 | Professional | 53 · Discontinued | $85.11 | $97.72 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $1,071.52 | Professional | 54 · Surgery only | $323.59 | $363.08 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $213.80 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $141.25 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $1,000.00 |
Where Nevada sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$1,413
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.