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 $446.68 Median $2,570.40 Typical High $6,165.95 | Facility | None | $446.68 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $602.56 | Professional | None | $407.38 | $407.38 | $602.56 |
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 $426.58 Median $512.86 Typical High $851.14 | Professional | None | $426.58 | $512.86 | $851.14 |
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 $338.84 Median $338.84 Typical High $676.08 | Professional | None | $338.84 | $338.84 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $426.58 Typical High $630.96 | Professional | None | $9.55 | $426.58 | $630.96 |
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 $8.32 Median $8.32 Typical High $562.34 | Professional | None | $8.32 | $8.32 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $4,265.80 | Facility | None | $371.54 | $371.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $3,311.31 | Facility | None | $954.99 | $1,348.96 | $3,311.31 |
United Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $776.25 | Professional | None | $371.54 | $446.68 | $776.25 |
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 $204.17 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $316.23 |
Where Nevada sits
The same service costs 10.2 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· 35th of 51
$550
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.