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 $588.84 Median $3,981.07 Typical High $10,715.19 | Facility | None | $588.84 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | None | $588.84 | $588.84 | $741.31 |
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 $562.34 Median $691.83 Typical High $1,230.27 | Professional | None | $562.34 | $691.83 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,548.82 | Facility | None | $691.83 | $1,122.02 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $933.25 | Professional | None | $489.78 | $501.19 | $933.25 |
Hometown Health Setting Professional Modifier None Typical Low $15.49 Median $588.84 Typical High $912.01 | Professional | None | $15.49 | $588.84 | $912.01 |
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 $13.18 Median $13.18 Typical High $794.33 | Professional | None | $13.18 | $13.18 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $4,265.80 | Facility | None | $524.81 | $524.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,621.81 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,122.02 | Professional | None | $524.81 | $691.83 | $1,122.02 |
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 $295.12 Median $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $295.12 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $446.68 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $512.86 |
Where Nevada sits
The same service costs 5.2 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· 39th of 51
$741
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.