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 $954.99 Median $2,238.72 Typical High $5,128.61 | Facility | None | $954.99 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,621.81 | $1,862.09 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $2,137.96 | Facility | None | $562.34 | $758.58 | $2,137.96 |
Hometown Health Setting Professional Modifier None Typical Low $9,772.37 Median $10,964.78 Typical High $15,488.17 | Professional | None | $9,772.37 | $10,964.78 | $15,488.17 |
Hometown Health Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $4,265.80 | Facility | None | $977.24 | $977.24 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,230.27 | Professional | None | $794.33 | $891.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,659.59 | Professional | None | $870.96 | $1,202.26 | $1,659.59 |
5 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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Where Nevada sits
The same service costs 50.1 times more in Oklahoma than in North Carolina. 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· 24th of 51
$1,622
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.