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 $1,949.84 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,949.84 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,949.84 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $9,120.11 Typical High $17,378.01 | Facility | None | $4,570.88 | $9,120.11 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $4,168.69 | Professional | None | $1,862.09 | $2,290.87 | $4,168.69 |
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 $1,584.89 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,584.89 | $3,090.30 |
Hometown Health Setting Professional Modifier None Typical Low $26.30 Median $1,819.70 Typical High $3,019.95 | Professional | None | $26.30 | $1,819.70 | $3,019.95 |
Hometown Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $2,691.53 | Professional | None | $22.91 | $22.91 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $4,265.80 | Facility | None | $1,778.28 | $1,778.28 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,737.80 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,737.80 | $2,041.74 | $3,162.28 |
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 $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $977.24 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,445.44 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,380.38 | $1,380.38 |
Where Nevada sits
The same service costs 5.9 times more in Alaska than in Texas. 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· 39th of 51
$2,089
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.