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 $1,479.11 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $8,511.38 | Facility | None | $2,754.23 | $4,570.88 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,548.82 | $2,511.89 |
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 $851.14 Median $1,122.02 Typical High $1,819.70 | Professional | None | $851.14 | $1,122.02 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $20.89 Median $1,258.93 Typical High $1,778.28 | Professional | None | $20.89 | $1,258.93 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $1,862.09 | Professional | None | $15.49 | $15.49 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $4,265.80 | Facility | None | $1,258.93 | $1,258.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,398.83 | Professional | None | $851.14 | $1,122.02 | $2,398.83 |
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 $1,096.48 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,348.96 | $1,698.24 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
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· 36th of 51
$1,445
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.