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 $446.68 Median $3,162.28 Typical High $7,244.36 | Facility | None | $446.68 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | None | $436.52 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $741.31 | Professional | None | $407.38 | $467.74 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $2,630.27 | Facility | None | $724.44 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $549.54 | Professional | None | $316.23 | $338.84 | $549.54 |
Hometown Health Setting Professional Modifier None Typical Low $10.96 Median $389.05 Typical High $562.34 | Professional | None | $10.96 | $389.05 | $562.34 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $588.84 | Professional | None | $8.13 | $8.13 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $4,265.80 | Facility | None | $389.05 | $389.05 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $812.83 | Professional | None | $257.04 | $354.81 | $812.83 |
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 $331.13 Median $416.87 Typical High $562.34 | Professional | None | $331.13 | $416.87 | $562.34 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $309.03 |
Where Nevada sits
The same service costs 5.6 times more in Alaska than in Utah. 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
$437
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.