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 $1,000.00 Median $2,238.72 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | None | $812.83 | $812.83 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $10,000.00 Typical High $12,302.69 | Facility | None | $5,495.41 | $10,000.00 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,698.24 | Professional | None | $776.25 | $933.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $18,197.01 Typical High $26,302.68 | Facility | None | $501.19 | $18,197.01 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,288.25 | Professional | None | $660.69 | $660.69 | $1,288.25 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $812.83 Typical High $1,230.27 | Professional | None | $9.55 | $812.83 | $1,230.27 |
Hometown Health Setting Facility Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $18,197.01 | Facility | None | $18,197.01 | $18,197.01 | $18,197.01 |
Hometown Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $1,071.52 | Professional | None | $8.13 | $8.13 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $4,265.80 | Facility | None | $707.95 | $707.95 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $5,128.61 Typical High $12,022.64 | Facility | None | $2,570.40 | $5,128.61 | $12,022.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,318.26 | Professional | None | $645.65 | $851.14 | $1,318.26 |
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 $407.38 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $691.83 |
Where Nevada sits
The same service costs 6.8 times more in Alaska than in Texas. 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· 36th of 51
$1,000
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.