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 $4,570.88 Typical High $10,715.19 | Facility | None | $2,238.72 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $4,168.69 Median $4,786.30 Typical High $7,762.47 | Professional | None | $4,168.69 | $4,786.30 | $7,762.47 |
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 $1,995.26 Median $3,090.30 Typical High $5,495.41 | Professional | None | $1,995.26 | $3,090.30 | $5,495.41 |
Hometown Health Setting Professional Modifier None Typical Low $39.81 Median $3,715.35 Typical High $5,370.32 | Professional | None | $39.81 | $3,715.35 | $5,370.32 |
Hometown Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $5,754.40 | Professional | None | $30.20 | $30.20 | $5,754.40 |
Select Health Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,265.80 | Facility | None | $3,801.89 | $3,801.89 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $7,244.36 | Professional | None | $2,630.27 | $3,467.37 | $7,244.36 |
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 $2,511.89 Median $3,890.45 Typical High $5,128.61 | Professional | None | $2,511.89 | $3,890.45 | $5,128.61 |
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $3,467.37 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,235.94 | $3,235.94 |
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
$4,365
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.