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 $1,096.48 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,096.48 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,071.52 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,230.27 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $4,168.69 | Facility | None | $724.44 | $3,019.95 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,778.28 | Professional | None | $831.76 | $954.99 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $933.25 Typical High $1,584.89 | Professional | None | $9.55 | $933.25 | $1,584.89 |
Hometown Health Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Hometown Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $1,412.54 | Professional | None | $7.24 | $7.24 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $4,265.80 | Facility | None | $933.25 | $933.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,905.46 | Professional | None | $741.31 | $933.25 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,659.59 | Professional | None | $812.83 | $1,122.02 | $1,659.59 |
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 $537.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $758.58 |
Where Nevada sits
The same service costs 6.3 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· 36th of 51
$1,230
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.