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 $2,187.76 Median $3,981.07 Typical High $10,715.19 | Facility | None | $2,187.76 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,187.76 | $2,238.72 | $2,238.72 |
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 $2,137.96 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,137.96 | $2,570.40 | $4,677.35 |
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 $1,659.59 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,659.59 | $1,659.59 | $3,548.13 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $1,819.70 Typical High $3,388.44 | Professional | None | $28.18 | $1,819.70 | $3,388.44 |
Hometown Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $3,019.95 | Professional | None | $23.99 | $23.99 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $4,265.80 | Facility | None | $1,995.26 | $1,995.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $2,238.72 Typical High $3,388.44 | Professional | None | $1,737.80 | $2,238.72 | $3,388.44 |
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 $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,659.59 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,584.89 | $1,584.89 |
Where Nevada sits
The same service costs 8.1 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
$2,291
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.