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 $758.58 Median $3,162.28 Typical High $7,244.36 | Facility | None | $758.58 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | None | $602.56 | $602.56 | $776.25 |
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 $575.44 Median $707.95 Typical High $1,288.25 | Professional | None | $575.44 | $707.95 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,905.46 Typical High $2,630.27 | Facility | None | $758.58 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $954.99 | Professional | None | $489.78 | $512.86 | $954.99 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $602.56 Typical High $933.25 | Professional | None | $10.47 | $602.56 | $933.25 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $812.83 | Professional | None | $8.91 | $8.91 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $4,265.80 | Facility | None | $537.03 | $537.03 | $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 $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 $537.03 Median $660.69 Typical High $1,096.48 | Professional | None | $537.03 | $660.69 | $1,096.48 |
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 $302.00 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $524.81 |
Where Nevada sits
The same service costs 5.4 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· 41st of 51
$759
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.