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 $501.19 Median $2,238.72 Typical High $5,128.61 | Facility | None | $501.19 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $524.81 | Professional | None | $407.38 | $407.38 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $870.96 | Professional | None | $389.05 | $467.74 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $2,570.40 | Facility | None | $501.19 | $1,819.70 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $660.69 | Professional | None | $338.84 | $354.81 | $660.69 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $416.87 Typical High $616.60 | Professional | None | $3.63 | $416.87 | $616.60 |
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 $3.09 Median $3.09 Typical High $549.54 | Professional | None | $3.09 | $3.09 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $4,265.80 | Facility | None | $363.08 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $363.08 Median $436.52 Typical High $741.31 | Professional | None | $363.08 | $436.52 | $741.31 |
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 $204.17 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $346.74 |
Where Nevada sits
The same service costs 6.2 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· 38th of 51
$513
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.