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 $549.54 Median $3,162.28 Typical High $7,244.36 | Facility | None | $549.54 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $4,168.69 | Professional | None | $537.03 | $549.54 | $4,168.69 |
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 $478.63 Median $575.44 Typical High $1,071.52 | Professional | None | $478.63 | $575.44 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,570.40 Typical High $3,467.37 | Facility | None | $724.44 | $2,570.40 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $794.33 | Professional | None | $380.19 | $426.58 | $794.33 |
Hometown Health Setting Professional Modifier None Typical Low $10.96 Median $537.03 Typical High $812.83 | Professional | None | $10.96 | $537.03 | $812.83 |
Hometown Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $691.83 | Professional | None | $9.33 | $9.33 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $4,265.80 | Facility | None | $467.74 | $467.74 | $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 $371.54 Median $575.44 Typical High $977.24 | Professional | None | $371.54 | $575.44 | $977.24 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Where Nevada sits
The same service costs 5.4 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· 23rd of 51
$933
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.