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 $537.03 Median $3,162.28 Typical High $5,011.87 | Facility | None | $537.03 | $3,162.28 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $2,290.87 Typical High $2,691.53 | Professional | None | $446.68 | $2,290.87 | $2,691.53 |
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 $426.58 Median $501.19 Typical High $741.31 | Professional | None | $426.58 | $501.19 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,715.35 Typical High $5,248.07 | Facility | None | $691.83 | $3,715.35 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $1,862.09 Typical High $3,162.28 | Professional | None | $323.59 | $1,862.09 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $407.38 Median $2,238.72 Typical High $3,630.78 | Professional | None | $407.38 | $2,238.72 | $3,630.78 |
Hometown Health Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Hometown Health Setting Professional Modifier None Typical Low $4.57 Median $575.44 Typical High $5,495.41 | Professional | None | $4.57 | $575.44 | $5,495.41 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $2,089.30 Typical High $4,265.80 | Facility | None | $380.19 | $2,089.30 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $2,089.30 | Professional | None | $363.08 | $562.34 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,621.81 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $416.87 Median $1,949.84 Typical High $3,162.28 | Professional | None | $416.87 | $1,949.84 | $3,162.28 |
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 $223.87 Median $338.84 Typical High $1,348.96 | Professional | 52 · Reduced service | $223.87 | $338.84 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $134.90 Typical High $537.03 | Professional | 53 · Discontinued | $89.13 | $134.90 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $501.19 Typical High $2,041.74 | Professional | 54 · Surgery only | $338.84 | $501.19 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $100.00 Typical High $407.38 | Professional | 55 · Aftercare only | $67.61 | $100.00 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $67.61 Typical High $269.15 | Professional | 56 · Pre-op care only | $44.67 | $67.61 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $467.74 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $316.23 | $467.74 | $1,905.46 |
Where Nevada sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 22nd of 51
$2,089
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.