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 $645.65 Median $1,659.59 Typical High $5,888.44 | Facility | None | $645.65 | $1,659.59 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,174.90 | Professional | None | $575.44 | $724.44 | $1,174.90 |
BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $7,079.46 | Facility | None | $1,698.24 | $2,630.27 | $7,079.46 |
BCBS Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,380.38 | Professional | None | $691.83 | $954.99 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $2,570.40 | Facility | None | $741.31 | $2,041.74 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,380.38 | Professional | None | $645.65 | $870.96 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,995.26 | Professional | None | $707.95 | $1,096.48 | $1,995.26 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,047.13 | Professional | None | $776.25 | $812.83 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,479.11 | Professional | None | $645.65 | $933.25 | $1,479.11 |
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 $275.42 Median $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $275.42 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $501.19 |
Where Illinois sits
The same service costs 4.5 times more in Alaska 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.
Illinois· 17th of 51
$955
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.