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 $2,238.72 Median $4,786.30 Typical High $10,715.19 | Facility | None | $2,238.72 | $4,786.30 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $14,454.40 | Facility | None | $2,951.21 | $5,623.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,365.16 Median $4,897.79 Typical High $8,128.31 | Professional | None | $4,365.16 | $4,897.79 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $3,715.35 Typical High $5,888.44 | Professional | None | $1,778.28 | $3,715.35 | $5,888.44 |
Hometown Health Setting Professional Modifier None Typical Low $42.66 Median $4,168.69 Typical High $5,754.40 | Professional | None | $42.66 | $4,168.69 | $5,754.40 |
Hometown Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $6,025.60 | Professional | None | $31.62 | $31.62 | $6,025.60 |
Select Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,265.80 | Facility | None | $3,981.07 | $3,981.07 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $7,585.78 | Professional | None | $2,691.53 | $3,548.13 | $7,585.78 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $4,168.69 Typical High $5,495.41 | Professional | None | $2,290.87 | $4,168.69 | $5,495.41 |
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 $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $3,548.13 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $3,311.31 | $3,311.31 | $3,311.31 |
Where Nevada sits
The same service costs 21.4 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· 37th of 51
$4,571
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.