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 $61.66 Median $1,258.93 Typical High $5,623.41 | Facility | None | $61.66 | $1,258.93 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $114.82 | Professional | None | $47.86 | $61.66 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $87.10 | Professional | None | $53.70 | $83.18 | $87.10 |
BCBS Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $977.24 | Facility | None | $257.04 | $302.00 | $977.24 |
BCBS Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $112.20 | Professional | None | $57.54 | $77.62 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $114.82 | Professional | None | $52.48 | $74.13 | $114.82 |
Hally Health Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $173.78 | Professional | None | $61.66 | $93.33 | $173.78 |
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 $66.07 Median $67.61 Typical High $89.13 | Professional | None | $66.07 | $67.61 | $89.13 |
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 $141.25 Median $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $128.82 | Professional | None | $52.48 | $79.43 | $128.82 |
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 $22.91 Median $27.54 Typical High $30.20 | Professional | 52 · Reduced service | $22.91 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.96 Typical High $12.30 | Professional | 53 · Discontinued | $9.12 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $41.69 Typical High $45.71 | Professional | 54 · Surgery only | $34.67 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $9.12 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.50 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.57 | $5.50 | $6.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $38.90 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $32.36 | $38.90 | $42.66 |
Where Illinois sits
The same service costs 4.2 times more in Alaska 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.
Illinois· 26th of 51
$77.62
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.