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 $1,778.28 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,778.28 | $1,778.28 |
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 $1,698.24 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,698.24 | $1,949.84 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $15,135.61 | Facility | None | $1,148.15 | $1,513.56 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,479.11 | $2,570.40 |
Hometown Health Setting Professional Modifier None Typical Low $30.20 Median $1,479.11 Typical High $2,570.40 | Professional | None | $30.20 | $1,479.11 | $2,570.40 |
Hometown Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $2,454.71 | Professional | None | $22.91 | $22.91 | $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 $1,318.26 Median $1,621.81 Typical High $4,168.69 | Professional | None | $1,318.26 | $1,621.81 | $4,168.69 |
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 $1,348.96 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,659.59 | $2,630.27 |
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 $870.96 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $870.96 | $891.25 | $891.25 |
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 $1,318.26 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,318.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,258.93 | $1,258.93 |
Where Nevada sits
The same service costs 6.0 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· 42nd of 51
$1,778
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.