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 $288.40 Median $2,238.72 Typical High $5,011.87 | Facility | None | $288.40 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $407.38 | Professional | None | $288.40 | $407.38 | $407.38 |
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 $269.15 Median $407.38 Typical High $645.65 | Professional | None | $269.15 | $407.38 | $645.65 |
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 $229.09 Median $380.19 Typical High $616.60 | Professional | None | $229.09 | $380.19 | $616.60 |
Hometown Health Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $2,137.96 | Professional | None | $257.04 | $436.52 | $2,137.96 |
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 $2.57 Median $380.19 Typical High $2,691.53 | Professional | None | $2.57 | $380.19 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $4,265.80 | Facility | None | $257.04 | $389.05 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $257.04 Median $407.38 Typical High $676.08 | Professional | None | $257.04 | $407.38 | $676.08 |
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 $144.54 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $144.54 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $295.12 Typical High $302.00 | Professional | 54 · Surgery only | $218.78 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $58.88 Typical High $60.26 | Professional | 55 · Aftercare only | $43.65 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $275.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $204.17 | $275.42 | $281.84 |
Where Nevada sits
The same service costs 4.8 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· 43rd of 51
$427
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.