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 $691.83 Median $2,570.40 Typical High $6,165.95 | Facility | None | $691.83 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,000.00 | Professional | None | $676.08 | $676.08 | $1,000.00 |
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 $660.69 Median $812.83 Typical High $1,479.11 | Professional | None | $660.69 | $812.83 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $758.58 Typical High $1,023.29 | Facility | None | $616.60 | $758.58 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $1,071.52 | Professional | None | $575.44 | $588.84 | $1,071.52 |
Hometown Health Setting Professional Modifier None Typical Low $4.90 Median $676.08 Typical High $1,000.00 | Professional | None | $4.90 | $676.08 | $1,000.00 |
Hometown Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $891.25 | Professional | None | $4.17 | $4.17 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $4,265.80 | Facility | None | $588.84 | $588.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,047.13 | Professional | None | $588.84 | $707.95 | $1,047.13 |
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 $338.84 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $501.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $478.63 |
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· 37th of 51
$759
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.