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 $794.33 Median $3,981.07 Typical High $10,715.19 | Facility | None | $794.33 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | None | $794.33 | $794.33 | $870.96 |
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 $831.76 Median $1,000.00 Typical High $1,778.28 | Professional | None | $831.76 | $1,000.00 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,348.96 | Professional | None | $691.83 | $691.83 | $1,348.96 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $831.76 Typical High $1,258.93 | Professional | None | $12.02 | $831.76 | $1,258.93 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $1,096.48 | Professional | None | $10.47 | $10.47 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $4,265.80 | Facility | None | $724.44 | $724.44 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,288.25 | Professional | None | $724.44 | $870.96 | $1,288.25 |
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 $398.11 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $616.60 |
Where Nevada sits
The same service costs 6.3 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· 39th of 51
$933
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.