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 $954.99 Median $4,897.79 Typical High $8,128.31 | Facility | None | $954.99 | $4,897.79 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Professional | None | $870.96 | $870.96 | $1,122.02 |
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 $912.01 Median $1,096.48 Typical High $1,905.46 | Professional | None | $912.01 | $1,096.48 | $1,905.46 |
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 $776.25 Median $776.25 Typical High $1,479.11 | Professional | None | $776.25 | $776.25 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $14.45 Median $912.01 Typical High $1,380.38 | Professional | None | $14.45 | $912.01 | $1,380.38 |
Hometown Health Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $1,202.26 | Professional | None | $12.30 | $12.30 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $4,265.80 | Facility | None | $794.33 | $794.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $794.33 Median $954.99 Typical High $1,445.44 | Professional | None | $794.33 | $954.99 | $1,445.44 |
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 $436.52 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $676.08 |
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· 38th of 51
$1,047
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.