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 $467.74 Median $3,162.28 Typical High $7,244.36 | Facility | None | $467.74 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $660.69 | Professional | None | $467.74 | $467.74 | $660.69 |
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 $446.68 Median $537.03 Typical High $977.24 | Professional | None | $446.68 | $537.03 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $2,630.27 | Facility | None | $724.44 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $724.44 | Professional | None | $380.19 | $380.19 | $724.44 |
Hometown Health Setting Professional Modifier None Typical Low $9.12 Median $478.63 Typical High $724.44 | Professional | None | $9.12 | $478.63 | $724.44 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $616.60 | Professional | None | $7.76 | $7.76 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $4,265.80 | Facility | None | $407.38 | $407.38 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $724.44 | Professional | None | $407.38 | $489.78 | $724.44 |
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 $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $331.13 |
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· 41st of 51
$589
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.