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 $389.05 Median $2,238.72 Typical High $5,128.61 | Facility | None | $389.05 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | None | $354.81 | $354.81 | $446.68 |
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 $371.54 Median $446.68 Typical High $758.58 | Professional | None | $371.54 | $446.68 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $2,630.27 | Facility | None | $794.33 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $602.56 | Professional | None | $309.03 | $309.03 | $602.56 |
Hometown Health Setting Professional Modifier None Typical Low $8.13 Median $371.54 Typical High $575.44 | Professional | None | $8.13 | $371.54 | $575.44 |
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 $6.92 Median $6.92 Typical High $489.78 | Professional | None | $6.92 | $6.92 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $4,265.80 | Facility | None | $323.59 | $323.59 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $323.59 Median $398.11 Typical High $676.08 | Professional | None | $323.59 | $398.11 | $676.08 |
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 $177.83 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $269.15 |
Where Nevada sits
The same service costs 7.1 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· 37th of 51
$479
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.