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 $1,737.80 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,737.80 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,659.59 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,659.59 | $2,041.74 | $3,630.78 |
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 $1,445.44 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,445.44 | $2,754.23 |
Hometown Health Setting Professional Modifier None Typical Low $22.39 Median $1,819.70 Typical High $2,754.23 | Professional | None | $22.39 | $1,819.70 | $2,754.23 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $2,454.71 | Professional | None | $19.05 | $19.05 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $4,265.80 | Facility | None | $1,621.81 | $1,621.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $1,445.44 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,819.70 | $2,754.23 |
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 $851.14 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,288.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,230.27 | $1,230.27 |
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· 37th of 51
$1,905
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.