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 $134.90 Median $2,238.72 Typical High $5,011.87 | Facility | None | $134.90 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $218.78 | Professional | None | $128.82 | $208.93 | $218.78 |
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 $128.82 Median $213.80 Typical High $354.81 | Professional | None | $128.82 | $213.80 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $912.01 | Facility | None | $169.82 | $213.80 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $281.84 | Professional | None | $109.65 | $181.97 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $323.59 | Professional | None | $120.23 | $204.17 | $323.59 |
Hometown Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Hometown Health Setting Professional Modifier None Typical Low $0.66 Median $177.83 Typical High $316.23 | Professional | None | $0.66 | $177.83 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $208.93 Typical High $4,265.80 | Facility | None | $120.23 | $208.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $295.12 | Professional | None | $114.82 | $199.53 | $295.12 |
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 $64.57 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $64.57 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $43.65 | Professional | 53 · Discontinued | $25.70 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $165.96 | Professional | 54 · Surgery only | $97.72 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $154.88 |
Where Nevada sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 38th of 51
$214
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.