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 $1,479.11 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $7,943.28 | Facility | None | $2,754.23 | $4,570.88 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,621.81 | $2,511.89 |
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 $954.99 Median $1,202.26 Typical High $2,137.96 | Professional | None | $954.99 | $1,202.26 | $2,137.96 |
Hometown Health Setting Professional Modifier None Typical Low $22.39 Median $1,230.27 Typical High $2,187.76 | Professional | None | $22.39 | $1,230.27 | $2,187.76 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $2,089.30 | Professional | None | $16.98 | $16.98 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $4,265.80 | Facility | None | $1,380.38 | $1,380.38 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $3,548.13 | Professional | None | $1,122.02 | $1,380.38 | $3,548.13 |
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 $1,202.26 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,445.44 | $2,041.74 |
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 $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $295.12 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,047.13 |
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
$1,479
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.