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 $2,238.72 Median $4,265.80 Typical High $10,715.19 | Facility | None | $2,238.72 | $4,265.80 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $6,606.93 | Facility | None | $2,754.23 | $4,570.88 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $7,079.46 | Professional | None | $3,890.45 | $4,365.16 | $7,079.46 |
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 $1,819.70 Median $2,884.03 Typical High $5,128.61 | Professional | None | $1,819.70 | $2,884.03 | $5,128.61 |
Hometown Health Setting Professional Modifier None Typical Low $36.31 Median $3,388.44 Typical High $4,897.79 | Professional | None | $36.31 | $3,388.44 | $4,897.79 |
Hometown Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $5,248.07 | Professional | None | $26.92 | $26.92 | $5,248.07 |
Select Health Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,265.80 | Facility | None | $3,548.13 | $3,548.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $6,760.83 | Professional | None | $2,398.83 | $3,162.28 | $6,760.83 |
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 $2,238.72 Median $3,715.35 Typical High $4,786.30 | Professional | None | $2,238.72 | $3,715.35 | $4,786.30 |
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $2,951.21 |
Where Nevada sits
The same service costs 21.9 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· 36th of 51
$3,981
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.