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 $407.38 Median $2,238.72 Typical High $5,128.61 | Facility | None | $407.38 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $691.83 | Professional | None | $371.54 | $426.58 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,513.56 Typical High $2,187.76 | Facility | None | $501.19 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $489.78 | Professional | None | $309.03 | $309.03 | $489.78 |
Hometown Health Setting Professional Modifier None Typical Low $6.46 Median $363.08 Typical High $537.03 | Professional | None | $6.46 | $363.08 | $537.03 |
Hometown Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $549.54 | Professional | None | $4.79 | $4.79 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $4,265.80 | Facility | None | $363.08 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $758.58 | Professional | None | $234.42 | $338.84 | $758.58 |
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 $281.84 Median $363.08 Typical High $501.19 | Professional | None | $281.84 | $363.08 | $501.19 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $281.84 |
Where Nevada sits
The same service costs 5.1 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· 37th of 51
$398
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.