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 $1,202.26 Median $2,238.72 Typical High $5,128.61 | Facility | None | $1,202.26 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
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 $977.24 Median $1,202.26 Typical High $2,187.76 | Professional | None | $977.24 | $1,202.26 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,513.56 | Facility | None | $676.08 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,659.59 | Professional | None | $851.14 | $870.96 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $1,047.13 Typical High $1,548.82 | Professional | None | $9.33 | $1,047.13 | $1,548.82 |
Hometown Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $1,348.96 | Professional | None | $8.13 | $8.13 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,265.80 | Facility | None | $912.01 | $912.01 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,584.89 | Professional | None | $831.76 | $1,071.52 | $1,584.89 |
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 $512.86 Median $512.86 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 53 · Discontinued | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $776.25 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $891.25 |
Where Nevada sits
The same service costs 5.9 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· 38th of 51
$1,175
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.