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 $1,380.38 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,380.38 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,348.96 | $1,380.38 | $1,380.38 |
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 $1,348.96 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,548.82 | $2,511.89 |
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 $1,071.52 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,202.26 | $2,187.76 |
Hometown Health Setting Professional Modifier None Typical Low $15.85 Median $1,202.26 Typical High $2,041.74 | Professional | None | $15.85 | $1,202.26 | $2,041.74 |
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 $12.02 Median $12.02 Typical High $1,819.70 | Professional | None | $12.02 | $12.02 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,265.80 | Facility | None | $1,202.26 | $1,202.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,454.71 | Professional | None | $977.24 | $1,202.26 | $2,454.71 |
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 $1,202.26 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,380.38 | $2,041.74 |
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 $676.08 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $676.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $977.24 |
Where Nevada sits
The same service costs 7.2 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
$1,549
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.