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 $346.74 Median $3,981.07 Typical High $5,248.07 | Facility | None | $346.74 | $3,981.07 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $478.63 | Professional | None | $323.59 | $371.54 | $478.63 |
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 $371.54 Median $446.68 Typical High $776.25 | Professional | None | $371.54 | $446.68 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $2,630.27 | Facility | None | $794.33 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $630.96 | Professional | None | $309.03 | $346.74 | $630.96 |
Hometown Health Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $2,187.76 | Professional | None | $323.59 | $457.09 | $2,187.76 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $2.51 Median $489.78 Typical High $2,691.53 | Professional | None | $2.51 | $489.78 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $416.87 Typical High $4,265.80 | Facility | None | $323.59 | $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 $338.84 Median $416.87 Typical High $676.08 | Professional | None | $338.84 | $416.87 | $676.08 |
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 $162.18 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $64.57 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $32.36 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $275.42 |
Where Nevada sits
The same service costs 3.8 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· 43rd of 51
$447
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.