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 $831.76 Median $3,981.07 Typical High $8,128.31 | Facility | None | $831.76 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,311.31 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,412.54 | Professional | None | $758.58 | $870.96 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,548.13 Typical High $17,782.79 | Facility | None | $870.96 | $3,548.13 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $1,047.13 | Professional | None | $588.84 | $630.96 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $23.99 Median $707.95 Typical High $1,071.52 | Professional | None | $23.99 | $707.95 | $1,071.52 |
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 $17.78 Median $17.78 Typical High $1,071.52 | Professional | None | $17.78 | $17.78 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $4,265.80 | Facility | None | $707.95 | $707.95 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,479.11 | Professional | None | $478.63 | $660.69 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,047.13 | Professional | None | $630.96 | $758.58 | $1,047.13 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Nevada sits
The same service costs 25.1 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· 35th of 51
$832
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.