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 $524.81 Median $3,981.07 Typical High $5,248.07 | Facility | None | $524.81 | $3,981.07 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $660.69 | Professional | None | $501.19 | $524.81 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $794.33 | Professional | None | $478.63 | $549.54 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $354.81 Typical High $602.56 | Facility | None | $302.00 | $354.81 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $977.24 | Professional | None | $426.58 | $616.60 | $977.24 |
Hometown Health Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $831.76 | Professional | None | $467.74 | $562.34 | $831.76 |
Hometown Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $7.24 Median $467.74 Typical High $776.25 | Professional | None | $7.24 | $467.74 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $512.86 Typical High $4,265.80 | Facility | None | $426.58 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,122.02 | Professional | None | $398.11 | $549.54 | $1,122.02 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $891.25 | Professional | None | $478.63 | $602.56 | $891.25 |
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 $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $102.33 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $371.54 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $371.54 | $436.52 |
Where Nevada sits
The same service costs 6.2 times more in Alaska 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· 39th of 51
$562
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.