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 $457.09 Median $2,238.72 Typical High $5,128.61 | Facility | None | $457.09 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | None | $446.68 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $831.76 | Professional | None | $457.09 | $524.81 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,445.44 | Facility | None | $501.19 | $1,000.00 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $691.83 | Professional | None | $323.59 | $389.05 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $389.05 Typical High $724.44 | Professional | None | $4.79 | $389.05 | $724.44 |
Hometown Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $645.65 | Professional | None | $3.63 | $3.63 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $4,265.80 | Facility | None | $426.58 | $426.58 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $851.14 | Professional | None | $338.84 | $426.58 | $851.14 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $691.83 | Professional | None | $398.11 | $467.74 | $691.83 |
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 $223.87 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $309.03 | $316.23 | $316.23 |
Where Nevada sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$513
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.