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 $794.33 Median $2,570.40 Typical High $6,165.95 | Facility | None | $794.33 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $831.76 | Professional | None | $645.65 | $645.65 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,348.96 | Professional | None | $616.60 | $741.31 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,884.03 Typical High $4,073.80 | Facility | None | $616.60 | $2,884.03 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,023.29 | Professional | None | $524.81 | $524.81 | $1,023.29 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $645.65 Typical High $1,000.00 | Professional | None | $10.00 | $645.65 | $1,000.00 |
Hometown Health Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Hometown Health Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $851.14 | Professional | None | $8.51 | $8.51 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $4,265.80 | Facility | None | $575.44 | $575.44 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $549.54 Median $691.83 Typical High $1,023.29 | Professional | None | $549.54 | $691.83 | $1,023.29 |
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 $323.59 Median $323.59 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $562.34 |
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· 39th of 51
$794
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.