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 $1,548.82 Median $2,884.03 Typical High $10,715.19 | Facility | None | $1,548.82 | $2,884.03 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $8,511.38 | Facility | None | $2,754.23 | $4,570.88 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,584.89 | $2,630.27 |
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 $870.96 Median $1,174.90 Typical High $1,862.09 | Professional | None | $870.96 | $1,174.90 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $19.50 Median $1,288.25 Typical High $1,862.09 | Professional | None | $19.50 | $1,288.25 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $1,949.84 | Professional | None | $14.45 | $14.45 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,265.80 | Facility | None | $1,288.25 | $1,288.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $2,511.89 | Professional | None | $870.96 | $1,148.15 | $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 $933.25 Median $1,380.38 Typical High $1,737.80 | Professional | None | $933.25 | $1,380.38 | $1,737.80 |
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 $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Where Nevada sits
The same service costs 5.2 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
$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.