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 $165.96 Median $1,318.26 Typical High $5,623.41 | Facility | None | $165.96 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $257.04 | Professional | None | $107.15 | $154.88 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
BCBS Setting Facility Modifier None Typical Low $165.96 Median $251.19 Typical High $1,288.25 | Facility | None | $165.96 | $251.19 | $1,288.25 |
BCBS Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $302.00 | Professional | None | $120.23 | $190.55 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $208.93 Typical High $295.12 | Facility | None | $114.82 | $208.93 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $309.03 | Professional | None | $112.20 | $177.83 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $371.54 | Professional | None | $134.90 | $229.09 | $371.54 |
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 $141.25 Median $147.91 Typical High $239.88 | Professional | None | $141.25 | $147.91 | $239.88 |
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 $117.49 Median $190.55 Typical High $316.23 | Professional | None | $117.49 | $190.55 | $316.23 |
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 $50.12 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $50.12 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $29.51 Typical High $33.11 | Professional | 53 · Discontinued | $20.42 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $112.20 Typical High $123.03 | Professional | 54 · Surgery only | $75.86 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $15.14 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.23 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $104.71 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $70.79 | $104.71 | $114.82 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 22nd of 51
$186
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.