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 $707.95 Median $3,981.07 Typical High $10,715.19 | Facility | None | $707.95 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | None | $707.95 | $707.95 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $11,220.18 | Facility | None | $4,897.79 | $8,128.31 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,584.89 | Professional | None | $758.58 | $912.01 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,388.44 Typical High $4,897.79 | Facility | None | $691.83 | $3,388.44 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,230.27 | Professional | None | $616.60 | $616.60 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $758.58 Typical High $1,202.26 | Professional | None | $13.18 | $758.58 | $1,202.26 |
Hometown Health Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $1,023.29 | Professional | None | $11.22 | $11.22 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $4,265.80 | Facility | None | $676.08 | $676.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,258.93 | Professional | None | $676.08 | $812.83 | $1,258.93 |
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 $354.81 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $549.54 |
Where Nevada sits
The same service costs 6.8 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· 39th of 51
$912
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.