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 $575.44 Median $3,162.28 Typical High $7,244.36 | Facility | None | $575.44 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | None | $512.86 | $512.86 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $12,022.64 | Facility | None | $2,951.21 | $5,623.41 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,122.02 | Professional | None | $549.54 | $660.69 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $6,309.57 | Facility | None | $562.34 | $758.58 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $870.96 | Professional | None | $436.52 | $436.52 | $870.96 |
Hometown Health Setting Professional Modifier None Typical Low $4.27 Median $537.03 Typical High $851.14 | Professional | None | $4.27 | $537.03 | $851.14 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $741.31 | Professional | None | $3.63 | $3.63 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $4,265.80 | Facility | None | $501.19 | $501.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $501.19 Median $588.84 Typical High $1,000.00 | Professional | None | $501.19 | $588.84 | $1,000.00 |
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 $257.04 Median $257.04 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $398.11 |
Where Nevada sits
The same service costs 6.0 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
$676
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.