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 $933.25 Median $3,981.07 Typical High $10,715.19 | Facility | None | $933.25 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | None | $933.25 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $15,488.17 | Facility | None | $2,951.21 | $5,623.41 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,698.24 | Professional | None | $912.01 | $1,047.13 | $1,698.24 |
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 $676.08 Median $758.58 Typical High $1,584.89 | Professional | None | $676.08 | $758.58 | $1,584.89 |
Hometown Health Setting Professional Modifier None Typical Low $20.42 Median $758.58 Typical High $1,348.96 | Professional | None | $20.42 | $758.58 | $1,348.96 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $1,258.93 | Professional | None | $15.14 | $15.14 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $4,265.80 | Facility | None | $851.14 | $851.14 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,737.80 | Professional | None | $676.08 | $851.14 | $1,737.80 |
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 $776.25 Median $933.25 Typical High $1,380.38 | Professional | None | $776.25 | $933.25 | $1,380.38 |
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 $467.74 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $691.83 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $660.69 |
Where Nevada sits
The same service costs 24.0 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· 39th of 51
$955
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.