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 $489.78 Median $2,570.40 Typical High $6,165.95 | Facility | None | $489.78 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $724.44 | Professional | None | $489.78 | $489.78 | $724.44 |
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 $524.81 Median $630.96 Typical High $1,071.52 | Professional | None | $524.81 | $630.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,737.80 Typical High $2,454.71 | Facility | None | $616.60 | $1,737.80 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $831.76 | Professional | None | $416.87 | $416.87 | $831.76 |
Hometown Health Setting Professional Modifier None Typical Low $4.57 Median $575.44 Typical High $870.96 | Professional | None | $4.57 | $575.44 | $870.96 |
Hometown Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $758.58 | Professional | None | $3.98 | $3.98 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $4,265.80 | Facility | None | $512.86 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $851.14 | Professional | None | $371.54 | $524.81 | $851.14 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $346.74 |
Where Nevada sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 39th of 51
$631
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.