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 $426.58 Median $2,238.72 Typical High $5,128.61 | Facility | None | $426.58 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $524.81 | Professional | None | $407.38 | $426.58 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $7,762.47 | Facility | None | $2,570.40 | $4,073.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $933.25 | Professional | None | $457.09 | $562.34 | $933.25 |
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 $380.19 Median $380.19 Typical High $741.31 | Professional | None | $380.19 | $380.19 | $741.31 |
Hometown Health Setting Professional Modifier None Typical Low $4.57 Median $467.74 Typical High $691.83 | Professional | None | $4.57 | $467.74 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $616.60 | Professional | None | $3.89 | $3.89 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $4,265.80 | Facility | None | $407.38 | $407.38 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $707.95 | Professional | None | $398.11 | $478.63 | $707.95 |
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 $199.53 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $302.00 |
Where Nevada sits
The same service costs 7.2 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· 34th 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.