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 $616.60 Median $2,238.72 Typical High $5,128.61 | Facility | None | $616.60 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $575.44 Median $645.65 Typical High $1,023.29 | Professional | None | $575.44 | $645.65 | $1,023.29 |
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 $389.05 Median $436.52 Typical High $741.31 | Professional | None | $389.05 | $436.52 | $741.31 |
Hometown Health Setting Professional Modifier None Typical Low $7.94 Median $537.03 Typical High $812.83 | Professional | None | $7.94 | $537.03 | $812.83 |
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 $6.03 Median $6.03 Typical High $831.76 | Professional | None | $6.03 | $6.03 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $4,265.80 | Facility | None | $562.34 | $562.34 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $1,122.02 | Professional | None | $363.08 | $512.86 | $1,122.02 |
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 $436.52 Median $562.34 Typical High $724.44 | Professional | None | $436.52 | $562.34 | $724.44 |
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 $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
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
$603
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.