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 $1,949.84 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,949.84 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,071.52 | $1,412.54 |
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 $1,096.48 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,348.96 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $5,888.44 Typical High $17,782.79 | Facility | None | $912.01 | $5,888.44 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,862.09 | Professional | None | $954.99 | $954.99 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $1,148.15 Typical High $1,698.24 | Professional | None | $15.14 | $1,148.15 | $1,698.24 |
Hometown Health Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $1,445.44 | Professional | None | $13.18 | $13.18 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $4,265.80 | Facility | None | $977.24 | $977.24 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $7,244.36 | Facility | None | $1,905.46 | $3,019.95 | $7,244.36 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,778.28 | Professional | None | $977.24 | $1,174.90 | $1,778.28 |
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 $537.03 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $213.80 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $794.33 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $812.83 |
Where Nevada sits
The same service costs 8.7 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· 37th of 51
$1,413
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.