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 $691.83 Median $3,162.28 Typical High $7,244.36 | Facility | None | $691.83 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | None | $588.84 | $588.84 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $870.96 | Professional | None | $562.34 | $630.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,698.24 | Facility | None | $758.58 | $1,202.26 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $851.14 | Professional | None | $426.58 | $602.56 | $851.14 |
Hometown Health Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $851.14 | Professional | None | $446.68 | $575.44 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $741.31 | Professional | None | $13.18 | $13.18 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $4,265.80 | Facility | None | $501.19 | $501.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $912.01 | Professional | None | $467.74 | $645.65 | $912.01 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $977.24 | Professional | None | $446.68 | $549.54 | $977.24 |
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 $295.12 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $436.52 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $489.78 |
Where Nevada sits
The same service costs 8.5 times more in Wyoming 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· 31st of 51
$692
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.