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 $1,202.26 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,202.26 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,000.00 | $1,258.93 |
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 $954.99 Median $1,096.48 Typical High $1,479.11 | Professional | None | $954.99 | $1,096.48 | $1,479.11 |
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 $602.56 Median $954.99 Typical High $1,445.44 | Professional | None | $602.56 | $954.99 | $1,445.44 |
Hometown Health Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,380.38 | Professional | None | $758.58 | $1,000.00 | $1,380.38 |
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 $10.47 Median $10.47 Typical High $1,258.93 | Professional | None | $10.47 | $10.47 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $4,265.80 | Facility | None | $851.14 | $851.14 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,412.54 | Professional | None | $794.33 | $1,096.48 | $1,412.54 |
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 $691.83 Median $954.99 Typical High $1,445.44 | Professional | None | $691.83 | $954.99 | $1,445.44 |
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 $501.19 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $831.76 |
Where Nevada sits
The same service costs 7.4 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· 34th of 51
$1,096
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.