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 $478.63 Median $2,238.72 Typical High $5,011.87 | Facility | None | $478.63 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $1,445.44 Typical High $1,778.28 | Professional | None | $389.05 | $1,445.44 | $1,778.28 |
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 $371.54 Median $1,348.96 Typical High $2,398.83 | Professional | None | $371.54 | $1,348.96 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $1,819.70 | Facility | None | $691.83 | $1,318.26 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $1,548.82 Typical High $2,511.89 | Professional | None | $524.81 | $1,548.82 | $2,511.89 |
Hometown Health Setting Professional Modifier None Typical Low $416.87 Median $1,380.38 Typical High $2,238.72 | Professional | None | $416.87 | $1,380.38 | $2,238.72 |
Hometown Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $6.92 Median $524.81 Typical High $2,089.30 | Professional | None | $6.92 | $524.81 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $1,380.38 Typical High $4,265.80 | Facility | None | $346.74 | $1,380.38 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,513.56 Typical High $3,548.13 | Professional | None | $380.19 | $1,513.56 | $3,548.13 |
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 $194.98 Median $562.34 Typical High $891.25 | Professional | 52 · Reduced service | $194.98 | $562.34 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $223.87 Typical High $354.81 | Professional | 53 · Discontinued | $77.62 | $223.87 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $831.76 Typical High $1,348.96 | Professional | 54 · Surgery only | $288.40 | $831.76 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $165.96 Typical High $269.15 | Professional | 55 · Aftercare only | $57.54 | $165.96 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $112.20 Typical High $177.83 | Professional | 56 · Pre-op care only | $38.90 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $776.25 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $269.15 | $776.25 | $1,258.93 |
Where Nevada sits
The same service costs 4.9 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· 29th of 51
$1,445
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.