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 $190.55 Median $2,238.72 Typical High $5,128.61 | Facility | None | $190.55 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Professional | None | $173.78 | $173.78 | $251.19 |
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 $181.97 Median $218.78 Typical High $363.08 | Professional | None | $181.97 | $218.78 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $1,949.84 | Facility | None | $691.83 | $1,380.38 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $288.40 | Professional | None | $141.25 | $141.25 | $288.40 |
Hometown Health Setting Professional Modifier None Typical Low $2.95 Median $177.83 Typical High $269.15 | Professional | None | $2.95 | $177.83 | $269.15 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $234.42 | Professional | None | $2.51 | $2.51 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $4,265.80 | Facility | None | $158.49 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $275.42 | Professional | None | $158.49 | $186.21 | $275.42 |
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 $85.11 Median $85.11 Typical High $95.50 | Professional | 52 · Reduced service | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $131.83 |
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· 38th of 51
$229
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.