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 $707.95 Median $2,570.40 Typical High $5,011.87 | Facility | None | $707.95 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $977.24 | Professional | None | $707.95 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,548.82 | Professional | None | $660.69 | $977.24 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $4,570.88 | Facility | None | $616.60 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,230.27 | Professional | None | $537.03 | $676.08 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $3,801.89 | Professional | None | $575.44 | $912.01 | $3,801.89 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $812.83 Typical High $4,786.30 | Professional | None | $4.79 | $812.83 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $831.76 Typical High $4,265.80 | Facility | None | $537.03 | $831.76 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $575.44 Median $851.14 Typical High $1,380.38 | Professional | None | $575.44 | $851.14 | $1,380.38 |
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 $354.81 Median $398.11 Typical High $489.78 | Professional | 52 · Reduced service | $354.81 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $144.54 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $741.31 | Professional | 54 · Surgery only | $537.03 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $147.91 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $691.83 |
Where Nevada sits
The same service costs 5.2 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· 33rd of 51
$977
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.