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 $831.76 Median $3,981.07 Typical High $8,128.31 | Facility | None | $831.76 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,096.48 | Professional | None | $758.58 | $758.58 | $1,096.48 |
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 $794.33 Median $954.99 Typical High $1,778.28 | Professional | None | $794.33 | $954.99 | $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 $575.44 Median $691.83 Typical High $1,288.25 | Professional | None | $575.44 | $691.83 | $1,288.25 |
Hometown Health Setting Professional Modifier None Typical Low $8.91 Median $812.83 Typical High $1,174.90 | Professional | None | $8.91 | $812.83 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $1,047.13 | Professional | None | $7.59 | $7.59 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $4,265.80 | Facility | None | $691.83 | $691.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $676.08 Median $831.76 Typical High $1,258.93 | Professional | None | $676.08 | $831.76 | $1,258.93 |
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 $380.19 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $588.84 |
Where Nevada sits
The same service costs 6.2 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
$912
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.