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 $616.60 Median $3,162.28 Typical High $7,244.36 | Facility | None | $616.60 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $851.14 | Professional | None | $588.84 | $588.84 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,311.31 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,258.93 | Professional | None | $588.84 | $707.95 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,311.31 Typical High $4,570.88 | Facility | None | $724.44 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $933.25 | Professional | None | $501.19 | $501.19 | $933.25 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $602.56 Typical High $891.25 | Professional | None | $10.00 | $602.56 | $891.25 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $776.25 | Professional | None | $8.71 | $8.71 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $4,265.80 | Facility | None | $512.86 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $512.86 Median $630.96 Typical High $912.01 | Professional | None | $512.86 | $630.96 | $912.01 |
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 $295.12 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $117.49 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | 54 · Surgery only | $446.68 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $436.52 |
Where Nevada sits
The same service costs 8.1 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· 36th of 51
$759
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.