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 $3,162.28 Typical High $7,244.36 | Facility | None | $724.44 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | None | $724.44 | $724.44 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,513.56 | Professional | None | $691.83 | $831.76 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $2,630.27 | Facility | None | $724.44 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,148.15 | Professional | None | $588.84 | $616.60 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $724.44 Typical High $1,096.48 | Professional | None | $10.47 | $724.44 | $1,096.48 |
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 $8.91 Median $8.91 Typical High $933.25 | Professional | None | $8.91 | $8.91 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $4,265.80 | Facility | None | $630.96 | $630.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,148.15 | Professional | None | $630.96 | $758.58 | $1,148.15 |
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 $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Nevada sits
The same service costs 5.8 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
$871
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.