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 $1,412.54 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,412.54 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $1,288.25 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,479.11 | $2,398.83 |
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 $891.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $891.25 | $1,096.48 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $17.78 Median $1,202.26 Typical High $1,698.24 | Professional | None | $17.78 | $1,202.26 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $1,778.28 | Professional | None | $13.18 | $13.18 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,265.80 | Facility | None | $1,202.26 | $1,202.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,290.87 | Professional | None | $812.83 | $1,071.52 | $2,290.87 |
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 $1,071.52 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,288.25 | $1,621.81 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Nevada sits
The same service costs 5.4 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
$1,380
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.