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 $602.56 Median $2,238.72 Typical High $5,128.61 | Facility | None | $602.56 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | None | $501.19 | $501.19 | $630.96 |
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 $478.63 Median $549.54 Typical High $741.31 | Professional | None | $478.63 | $549.54 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,290.87 Typical High $3,311.31 | Facility | None | $501.19 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $741.31 | Professional | None | $354.81 | $501.19 | $741.31 |
Hometown Health Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $741.31 | Professional | None | $389.05 | $537.03 | $741.31 |
Hometown Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $645.65 | Professional | None | $6.46 | $6.46 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $4,265.80 | Facility | None | $426.58 | $426.58 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,148.15 | Professional | None | $398.11 | $562.34 | $1,148.15 |
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 $389.05 Median $489.78 Typical High $741.31 | Professional | None | $389.05 | $489.78 | $741.31 |
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 $251.19 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $251.19 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $416.87 |
Where Nevada sits
The same service costs 7.9 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· 35th of 51
$589
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.