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 $676.08 Median $2,570.40 Typical High $6,165.95 | Facility | None | $676.08 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $616.60 Median $707.95 Typical High $1,148.15 | Professional | None | $616.60 | $707.95 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,584.89 Typical High $2,187.76 | Facility | None | $616.60 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $812.83 | Professional | None | $338.84 | $489.78 | $812.83 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $588.84 Typical High $870.96 | Professional | None | $12.02 | $588.84 | $870.96 |
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 $8.91 Median $8.91 Typical High $912.01 | Professional | None | $8.91 | $8.91 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $4,265.80 | Facility | None | $602.56 | $602.56 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $1,230.27 | Professional | None | $389.05 | $549.54 | $1,230.27 |
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 $446.68 Median $602.56 Typical High $776.25 | Professional | None | $446.68 | $602.56 | $776.25 |
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 $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $467.74 |
Where Nevada sits
The same service costs 5.6 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
$646
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.