How much rates vary
Facilitymedian $1,950 · 10th to 90th $724 to $4,467Professionalmedian $347 · 10th to 90th $224 to $589
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 $239.88 Median $2,238.72 Typical High $5,011.87 | Facility | None | $239.88 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $501.19 | Professional | None | $239.88 | $354.81 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $223.87 Median $346.74 Typical High $562.34 | Professional | None | $223.87 | $346.74 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,096.48 Typical High $1,548.82 | Facility | None | $537.03 | $1,096.48 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $549.54 | Professional | None | $190.55 | $338.84 | $549.54 |
Hometown Health Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $1,258.93 | Professional | None | $213.80 | $380.19 | $1,258.93 |
Hometown Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $3.24 Median $323.59 Typical High $1,584.89 | Professional | None | $3.24 | $323.59 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $4,265.80 | Facility | None | $213.80 | $346.74 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $223.87 Median $354.81 Typical High $602.56 | Professional | None | $223.87 | $354.81 | $602.56 |
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 $117.49 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $117.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $47.86 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $177.83 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.99 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $239.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $165.96 | $239.88 | $245.47 |
Where Nevada sits
The same service costs 4.6 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· 46th of 51
$363
AK $1,259UT $275
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.