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 $933.25 Median $3,162.28 Typical High $7,244.36 | Facility | None | $933.25 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,258.93 | Professional | None | $891.25 | $891.25 | $1,258.93 |
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 $831.76 Median $1,000.00 Typical High $1,659.59 | Professional | None | $831.76 | $1,000.00 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,311.31 Typical High $4,570.88 | Facility | None | $724.44 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,288.25 | Professional | None | $660.69 | $660.69 | $1,288.25 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $831.76 Typical High $1,258.93 | Professional | None | $11.22 | $831.76 | $1,258.93 |
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 $9.55 Median $9.55 Typical High $1,122.02 | Professional | None | $9.55 | $9.55 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $4,265.80 | Facility | None | $741.31 | $741.31 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $724.44 Median $870.96 Typical High $1,479.11 | Professional | None | $724.44 | $870.96 | $1,479.11 |
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 $436.52 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $645.65 |
Where Nevada sits
The same service costs 7.4 times more in Oklahoma than in Texas. 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· 38th of 51
$1,000
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.