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 $1,905.46 | Professional | None | $1,479.11 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $12,302.69 | Facility | None | $2,951.21 | $5,623.41 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,698.24 | $3,162.28 |
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 $1,202.26 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,230.27 | $2,344.23 |
Hometown Health Setting Professional Modifier None Typical Low $18.20 Median $1,479.11 Typical High $2,238.72 | Professional | None | $18.20 | $1,479.11 | $2,238.72 |
Hometown Health Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $1,905.46 | Professional | None | $15.49 | $15.49 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,265.80 | Facility | None | $1,288.25 | $1,288.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $1,288.25 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,584.89 | $2,398.83 |
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 $912.01 | Professional | 52 · Reduced service | $741.31 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | 53 · Discontinued | $295.12 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,288.25 |
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
$1,622
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.