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 $1,318.26 Median $4,897.79 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,897.79 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $4,365.16 | Professional | None | $1,174.90 | $1,174.90 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $18,197.01 Typical High $23,442.29 | Facility | None | $6,025.60 | $18,197.01 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,288.25 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $12,022.64 Median $14,791.08 Typical High $19,498.45 | Facility | None | $12,022.64 | $14,791.08 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,737.80 | Professional | None | $933.25 | $1,071.52 | $1,737.80 |
Hometown Health Setting Professional Modifier None Typical Low $23.44 Median $1,202.26 Typical High $1,659.59 | Professional | None | $23.44 | $1,202.26 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $1,412.54 | Professional | None | $23.44 | $23.44 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $4,265.80 | Facility | None | $933.25 | $933.25 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $11,481.54 | Facility | None | $1,905.46 | $3,019.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,905.46 | Professional | None | $977.24 | $1,230.27 | $1,905.46 |
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 $575.44 Median $575.44 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $933.25 |
Where Nevada sits
The same service costs 8.9 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· 22nd of 51
$1,820
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.