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 $562.34 Typical High $676.08 | Professional | None | $446.68 | $562.34 | $676.08 |
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 $426.58 Median $489.78 Typical High $707.95 | Professional | None | $426.58 | $489.78 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,659.59 | Facility | None | $724.44 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $831.76 | Professional | None | $436.52 | $562.34 | $831.76 |
Hometown Health Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $1,023.29 | Professional | None | $489.78 | $588.84 | $1,023.29 |
Hometown Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $8.71 Median $562.34 Typical High $1,698.24 | Professional | None | $8.71 | $562.34 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $549.54 Typical High $4,265.80 | Facility | None | $380.19 | $549.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $794.33 | Professional | None | $354.81 | $549.54 | $794.33 |
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 $407.38 Median $512.86 Typical High $812.83 | Professional | None | $407.38 | $512.86 | $812.83 |
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 $263.03 Typical High $338.84 | Professional | 52 · Reduced service | $223.87 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $134.90 | Professional | 53 · Discontinued | $89.13 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $501.19 | Professional | 54 · Surgery only | $331.13 | $398.11 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $67.61 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $371.54 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $309.03 | $371.54 | $467.74 |
Where Nevada sits
The same service costs 6.5 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· 37th of 51
$575
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.