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 $1,348.96 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,348.96 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,318.26 | $1,348.96 | $1,348.96 |
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 $1,318.26 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,513.56 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $4,365.16 Typical High $6,309.57 | Facility | None | $616.60 | $4,365.16 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,148.15 Typical High $1,995.26 | Professional | None | $407.38 | $1,148.15 | $1,995.26 |
Hometown Health Setting Professional Modifier None Typical Low $14.45 Median $1,148.15 Typical High $1,995.26 | Professional | None | $14.45 | $1,148.15 | $1,995.26 |
Hometown Health Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Hometown Health Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $1,737.80 | Professional | None | $10.72 | $10.72 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $4,265.80 | Facility | None | $1,174.90 | $1,174.90 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,398.83 | Professional | None | $933.25 | $1,174.90 | $2,398.83 |
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 $1,148.15 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,348.96 | $1,995.26 |
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 $660.69 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $933.25 |
Where Nevada sits
The same service costs 11.0 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· 37th 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.