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 $389.05 Median $2,570.40 Typical High $6,165.95 | Facility | None | $389.05 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $478.63 | Professional | None | $354.81 | $354.81 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,311.31 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $758.58 | Professional | None | $371.54 | $446.68 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,467.37 Typical High $17,782.79 | Facility | None | $630.96 | $3,467.37 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $602.56 | Professional | None | $309.03 | $316.23 | $602.56 |
Hometown Health Setting Professional Modifier None Typical Low $9.12 Median $380.19 Typical High $575.44 | Professional | None | $9.12 | $380.19 | $575.44 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $489.78 | Professional | None | $7.76 | $7.76 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $4,265.80 | Facility | None | $331.13 | $331.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $660.69 | Professional | None | $331.13 | $389.05 | $660.69 |
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 $177.83 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $269.15 |
Where Nevada sits
The same service costs 9.3 times more in Kansas 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
$501
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.