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 $501.19 Median $2,238.72 Typical High $5,128.61 | Facility | None | $501.19 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | None | $457.09 | $457.09 | $575.44 |
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 $489.78 Median $588.84 Typical High $954.99 | Professional | None | $489.78 | $588.84 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,398.83 Typical High $3,467.37 | Facility | None | $537.03 | $2,398.83 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $794.33 | Professional | None | $371.54 | $467.74 | $794.33 |
Hometown Health Setting Professional Modifier None Typical Low $5.13 Median $467.74 Typical High $707.95 | Professional | None | $5.13 | $467.74 | $707.95 |
Hometown Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Hometown Health Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $630.96 | Professional | None | $4.37 | $4.37 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $4,265.80 | Facility | None | $416.87 | $416.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
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 $416.87 Median $501.19 Typical High $831.76 | Professional | None | $416.87 | $501.19 | $831.76 |
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 $229.09 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $354.81 |
Where Nevada sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 34th of 51
$589
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.