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 $741.31 Median $2,570.40 Typical High $6,165.95 | Facility | None | $741.31 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,023.29 | Professional | None | $741.31 | $741.31 | $1,023.29 |
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 $691.83 Median $851.14 Typical High $1,548.82 | Professional | None | $691.83 | $851.14 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,884.03 Typical High $4,073.80 | Facility | None | $616.60 | $2,884.03 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $1,174.90 | Professional | None | $616.60 | $630.96 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $9.77 Median $724.44 Typical High $1,096.48 | Professional | None | $9.77 | $724.44 | $1,096.48 |
Hometown Health Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Hometown Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $954.99 | Professional | None | $8.32 | $8.32 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $4,265.80 | Facility | None | $645.65 | $645.65 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $645.65 Median $758.58 Typical High $1,174.90 | Professional | None | $645.65 | $758.58 | $1,174.90 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where Nevada sits
The same service costs 8.7 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· 37th of 51
$891
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.