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 $724.44 Median $2,238.72 Typical High $5,128.61 | Facility | None | $724.44 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,000.00 | Professional | None | $691.83 | $691.83 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,288.25 | Professional | None | $660.69 | $794.33 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,162.28 Typical High $4,570.88 | Facility | None | $501.19 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,023.29 | Professional | None | $512.86 | $512.86 | $1,023.29 |
Hometown Health Setting Professional Modifier None Typical Low $7.08 Median $645.65 Typical High $977.24 | Professional | None | $7.08 | $645.65 | $977.24 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $870.96 | Professional | None | $6.17 | $6.17 | $870.96 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,000.00 | Professional | None | $512.86 | $691.83 | $1,000.00 |
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 $346.74 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $138.04 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $512.86 |
Where Nevada sits
The same service costs 8.1 times more in Oklahoma 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· 39th of 51
$794
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.