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 $676.08 Median $1,698.24 Typical High $4,466.84 | Facility | None | $676.08 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $724.44 | Professional | None | $562.34 | $562.34 | $724.44 |
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 $537.03 Median $616.60 Typical High $831.76 | Professional | None | $537.03 | $616.60 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $1,905.46 | Facility | None | $398.11 | $1,318.26 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $831.76 | Professional | None | $346.74 | $524.81 | $831.76 |
Hometown Health Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $851.14 | Professional | None | $436.52 | $562.34 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $741.31 | Professional | None | $10.47 | $10.47 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $4,265.80 | Facility | None | $489.78 | $489.78 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,023.29 | Professional | None | $457.09 | $616.60 | $1,023.29 |
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 $380.19 Median $524.81 Typical High $870.96 | Professional | None | $380.19 | $524.81 | $870.96 |
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 $281.84 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 53 · Discontinued | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $478.63 |
Where Nevada sits
The same service costs 8.3 times more in Wyoming 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· 31st of 51
$661
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.