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 $371.54 Median $2,570.40 Typical High $5,011.87 | Facility | None | $371.54 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $588.84 | Professional | None | $316.23 | $489.78 | $588.84 |
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 $302.00 Median $346.74 Typical High $501.19 | Professional | None | $302.00 | $346.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,659.59 | Facility | None | $616.60 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $691.83 | Professional | None | $229.09 | $407.38 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $1,023.29 | Professional | None | $302.00 | $416.87 | $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 $3.09 Median $416.87 Typical High $1,698.24 | Professional | None | $3.09 | $416.87 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $478.63 Typical High $4,265.80 | Facility | None | $275.42 | $478.63 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $575.44 | Professional | None | $257.04 | $478.63 | $575.44 |
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 $144.54 Median $354.81 Typical High $645.65 | Professional | None | $144.54 | $354.81 | $645.65 |
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 $158.49 Median $186.21 Typical High $295.12 | Professional | 52 · Reduced service | $158.49 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $74.13 Typical High $117.49 | Professional | 53 · Discontinued | $63.10 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $446.68 | Professional | 54 · Surgery only | $234.42 | $281.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $56.23 Typical High $89.13 | Professional | 55 · Aftercare only | $46.77 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $37.15 Typical High $58.88 | Professional | 56 · Pre-op care only | $31.62 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $263.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $218.78 | $263.03 | $416.87 |
Where Nevada sits
The same service costs 5.9 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· 32nd of 51
$468
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.