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 $1,445.44 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,445.44 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,174.90 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $8,317.64 | Facility | None | $2,754.23 | $4,570.88 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,348.96 | $2,511.89 |
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 $954.99 Median $954.99 Typical High $1,862.09 | Professional | None | $954.99 | $954.99 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $19.50 Median $1,148.15 Typical High $1,778.28 | Professional | None | $19.50 | $1,148.15 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $1,513.56 | Professional | None | $16.98 | $16.98 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,000.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $1,000.00 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,258.93 | $1,862.09 |
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 $588.84 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,000.00 |
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· 34th of 51
$1,349
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.