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 $912.01 Median $3,981.07 Typical High $10,715.19 | Facility | None | $912.01 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
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 $870.96 Median $1,071.52 Typical High $1,905.46 | Professional | None | $870.96 | $1,071.52 | $1,905.46 |
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 $741.31 Median $741.31 Typical High $1,445.44 | Professional | None | $741.31 | $741.31 | $1,445.44 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $912.01 Typical High $1,412.54 | Professional | None | $11.22 | $912.01 | $1,412.54 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $1,202.26 | Professional | None | $9.55 | $9.55 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $4,265.80 | Facility | None | $794.33 | $794.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $794.33 Median $977.24 Typical High $1,445.44 | Professional | None | $794.33 | $977.24 | $1,445.44 |
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 $457.09 Median $457.09 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $794.33 |
Where Nevada sits
The same service costs 5.8 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· 36th of 51
$1,047
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.