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 $1,513.56 Median $2,884.03 Typical High $10,715.19 | Facility | None | $1,513.56 | $2,884.03 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,380.38 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,548.82 | $2,570.40 |
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 $1,023.29 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,202.26 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $19.95 Median $1,348.96 Typical High $1,949.84 | Professional | None | $19.95 | $1,348.96 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $1,949.84 | Professional | None | $15.14 | $15.14 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $4,265.80 | Facility | None | $1,318.26 | $1,318.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $2,511.89 | Professional | None | $851.14 | $1,174.90 | $2,511.89 |
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 $1,000.00 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,380.38 | $1,862.09 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
Where Nevada sits
The same service costs 5.5 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· 39th of 51
$1,479
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.