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 $758.58 Median $3,162.28 Typical High $7,244.36 | Facility | None | $758.58 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $954.99 | Professional | None | $707.95 | $758.58 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $12,022.64 | Facility | None | $2,951.21 | $5,623.41 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,698.24 | Professional | None | $812.83 | $977.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,318.26 | Professional | None | $691.83 | $691.83 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $812.83 Typical High $1,258.93 | Professional | None | $11.22 | $812.83 | $1,258.93 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $1,071.52 | Professional | None | $9.55 | $9.55 | $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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,258.93 | Professional | None | $645.65 | $870.96 | $1,258.93 |
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 $354.81 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $524.81 |
Where Nevada sits
The same service costs 8.5 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· 35th of 51
$977
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.