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 $575.44 Median $3,981.07 Typical High $8,128.31 | Facility | None | $575.44 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $758.58 | Professional | None | $524.81 | $524.81 | $758.58 |
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 $549.54 Median $660.69 Typical High $1,122.02 | Professional | None | $549.54 | $660.69 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,511.89 Typical High $3,467.37 | Facility | None | $831.76 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $891.25 | Professional | None | $478.63 | $524.81 | $891.25 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $549.54 Typical High $831.76 | Professional | None | $19.05 | $549.54 | $831.76 |
Hometown Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Hometown Health Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $724.44 | Professional | None | $16.60 | $16.60 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $4,265.80 | Facility | None | $478.63 | $478.63 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $478.63 Median $588.84 Typical High $851.14 | Professional | None | $478.63 | $588.84 | $851.14 |
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 $263.03 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $398.11 |
Where Nevada sits
The same service costs 8.3 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· 36th of 51
$724
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.