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 $1,148.15 Median $2,238.72 Typical High $5,128.61 | Facility | None | $1,148.15 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $1,071.52 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,230.27 | $1,995.26 |
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 $257.04 Median $891.25 Typical High $1,412.54 | Professional | None | $257.04 | $891.25 | $1,412.54 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $1,047.13 Typical High $1,479.11 | Professional | None | $11.22 | $1,047.13 | $1,479.11 |
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 $8.32 Median $8.32 Typical High $1,548.82 | Professional | None | $8.32 | $8.32 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,265.80 | Facility | None | $1,047.13 | $1,047.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,949.84 | Professional | None | $691.83 | $954.99 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,348.96 | Professional | None | $691.83 | $1,047.13 | $1,348.96 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Nevada sits
The same service costs 5.2 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· 37th of 51
$1,148
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.