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 $616.60 Median $3,981.07 Typical High $8,128.31 | Facility | None | $616.60 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $630.96 | Professional | None | $512.86 | $512.86 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $758.58 | Professional | None | $489.78 | $549.54 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $2,630.27 | Facility | None | $794.33 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $776.25 | Professional | None | $407.38 | $575.44 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $741.31 | Professional | None | $380.19 | $524.81 | $741.31 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $630.96 | Professional | None | $10.47 | $10.47 | $630.96 |
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 $891.25 | Professional | None | $398.11 | $562.34 | $891.25 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $891.25 | Professional | None | $426.58 | $512.86 | $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 $257.04 Median $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $426.58 |
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
$617
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.