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 $851.14 Median $4,897.79 Typical High $8,128.31 | Facility | None | $851.14 | $4,897.79 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $6,606.93 Typical High $14,125.38 | Facility | None | $3,311.31 | $6,606.93 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,445.44 | Professional | None | $776.25 | $870.96 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,309.57 Typical High $17,782.79 | Facility | None | $660.69 | $6,309.57 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,047.13 | Professional | None | $645.65 | $645.65 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $21.88 Median $724.44 Typical High $1,023.29 | Professional | None | $21.88 | $724.44 | $1,023.29 |
Hometown Health Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $1,071.52 | Professional | None | $16.22 | $16.22 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $4,265.80 | Facility | None | $724.44 | $724.44 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,412.54 | Professional | None | $478.63 | $645.65 | $1,412.54 |
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 $645.65 Median $794.33 Typical High $1,071.52 | Professional | None | $645.65 | $794.33 | $1,071.52 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Nevada sits
The same service costs 5.9 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· 40th of 51
$813
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.