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 $1,071.52 Median $4,897.79 Typical High $8,128.31 | Facility | None | $1,071.52 | $4,897.79 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,230.27 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $3,311.31 Typical High $4,570.88 | Facility | None | $1,096.48 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,659.59 | Professional | None | $870.96 | $891.25 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $10.96 Median $1,071.52 Typical High $1,513.56 | Professional | None | $10.96 | $1,071.52 | $1,513.56 |
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 $9.33 Median $9.33 Typical High $1,348.96 | Professional | None | $9.33 | $9.33 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $4,265.80 | Facility | None | $891.25 | $891.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $891.25 | $1,071.52 | $1,659.59 |
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 $512.86 Median $512.86 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $741.31 |
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· 37th of 51
$1,259
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.