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 $1,380.38 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,380.38 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,380.38 | $1,412.54 | $1,412.54 |
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 $1,348.96 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,621.81 | $2,691.53 |
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 $1,174.90 Median $1,174.90 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,174.90 | $2,238.72 |
Hometown Health Setting Professional Modifier None Typical Low $9.12 Median $1,380.38 Typical High $2,187.76 | Professional | None | $9.12 | $1,380.38 | $2,187.76 |
Hometown Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $1,949.84 | Professional | None | $7.76 | $7.76 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $4,265.80 | Facility | None | $1,318.26 | $1,318.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $1,148.15 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,445.44 | $2,238.72 |
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 $691.83 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $691.83 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,000.00 |
Where Nevada sits
The same service costs 5.8 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· 36th of 51
$1,549
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.