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 $758.58 Median $3,162.28 Typical High $7,244.36 | Facility | None | $758.58 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | None | $630.96 | $630.96 | $794.33 |
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 $602.56 Median $691.83 Typical High $933.25 | Professional | None | $602.56 | $691.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,698.24 | Facility | None | $758.58 | $1,202.26 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $933.25 | Professional | None | $380.19 | $575.44 | $933.25 |
Hometown Health Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $912.01 | Professional | None | $478.63 | $691.83 | $912.01 |
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 $5.37 Median $5.37 Typical High $794.33 | Professional | None | $5.37 | $5.37 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $4,265.80 | Facility | None | $537.03 | $537.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $977.24 | Professional | None | $501.19 | $707.95 | $977.24 |
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 $389.05 Median $588.84 Typical High $1,023.29 | Professional | None | $389.05 | $588.84 | $1,023.29 |
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 $316.23 Median $316.23 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $524.81 |
Where Nevada sits
The same service costs 7.6 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
$692
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.