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 $371.54 Median $3,981.07 Typical High $10,715.19 | Facility | None | $371.54 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $501.19 | Professional | None | $371.54 | $389.05 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $7,762.47 | Facility | None | $2,570.40 | $4,073.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $891.25 | Professional | None | $416.87 | $512.86 | $891.25 |
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 $354.81 Median $354.81 Typical High $691.83 | Professional | None | $354.81 | $354.81 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $426.58 Typical High $660.69 | Professional | None | $7.59 | $426.58 | $660.69 |
Hometown Health Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $562.34 | Professional | None | $6.61 | $6.61 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $4,265.80 | Facility | None | $371.54 | $371.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $371.54 Median $457.09 Typical High $660.69 | Professional | None | $371.54 | $457.09 | $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 $186.21 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $257.04 | $275.42 | $275.42 |
Where Nevada sits
The same service costs 5.0 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· 35th of 51
$513
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.