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 $724.44 Median $3,981.07 Typical High $10,715.19 | Facility | None | $724.44 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | None | $724.44 | $724.44 | $891.25 |
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 $691.83 Median $851.14 Typical High $1,513.56 | Professional | None | $691.83 | $851.14 | $1,513.56 |
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 $588.84 Median $588.84 Typical High $1,148.15 | Professional | None | $588.84 | $588.84 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $12.59 Median $724.44 Typical High $1,122.02 | Professional | None | $12.59 | $724.44 | $1,122.02 |
Hometown Health Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $954.99 | Professional | None | $10.72 | $10.72 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $4,265.80 | Facility | None | $645.65 | $645.65 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $3,311.31 | Facility | None | $954.99 | $1,348.96 | $3,311.31 |
United Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,348.96 | Professional | None | $645.65 | $776.25 | $1,348.96 |
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 $363.08 Median $363.08 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $630.96 |
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· 37th of 51
$891
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.