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 $302.00 Median $1,698.24 Typical High $4,466.84 | Facility | None | $302.00 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $338.84 | Professional | None | $275.42 | $275.42 | $338.84 |
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 $288.40 Median $346.74 Typical High $588.84 | Professional | None | $288.40 | $346.74 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,905.46 Typical High $2,630.27 | Facility | None | $691.83 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $457.09 | Professional | None | $234.42 | $234.42 | $457.09 |
Hometown Health Setting Professional Modifier None Typical Low $4.47 Median $288.40 Typical High $436.52 | Professional | None | $4.47 | $288.40 | $436.52 |
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 $3.80 Median $3.80 Typical High $380.19 | Professional | None | $3.80 | $3.80 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $4,265.80 | Facility | None | $251.19 | $251.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $251.19 Median $309.03 Typical High $512.86 | Professional | None | $251.19 | $309.03 | $512.86 |
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 $138.04 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $213.80 |
Where Nevada sits
The same service costs 6.0 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
$380
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.