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 $1,122.02 Median $2,238.72 Typical High $5,128.61 | Facility | None | $1,122.02 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $1,096.48 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,258.93 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,290.87 Typical High $3,235.94 | Facility | None | $501.19 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,819.70 | Professional | None | $891.25 | $977.24 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $12.88 Median $954.99 Typical High $1,698.24 | Professional | None | $12.88 | $954.99 | $1,698.24 |
Hometown Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $1,479.11 | Professional | None | $9.55 | $9.55 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,000.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $2,041.74 | Professional | None | $794.33 | $1,000.00 | $2,041.74 |
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 $977.24 Median $1,148.15 Typical High $1,698.24 | Professional | None | $977.24 | $1,148.15 | $1,698.24 |
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 $549.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $831.76 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $794.33 |
Where Nevada sits
The same service costs 6.2 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· 38th of 51
$1,259
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.