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 $851.14 Median $3,981.07 Typical High $8,128.31 | Facility | None | $851.14 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | None | $776.25 | $776.25 | $1,000.00 |
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 $812.83 Median $977.24 Typical High $1,737.80 | Professional | None | $812.83 | $977.24 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $17,782.79 | Facility | None | $758.58 | $5,888.44 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,258.93 | Professional | None | $660.69 | $707.95 | $1,258.93 |
Hometown Health Setting Professional Modifier None Typical Low $8.32 Median $812.83 Typical High $1,202.26 | Professional | None | $8.32 | $812.83 | $1,202.26 |
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 $7.24 Median $7.24 Typical High $1,071.52 | Professional | None | $7.24 | $7.24 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $4,265.80 | Facility | None | $707.95 | $707.95 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,288.25 | Professional | None | $691.83 | $851.14 | $1,288.25 |
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 $389.05 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $588.84 |
Where Nevada sits
The same service costs 11.0 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
$1,047
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.