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 $933.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,148.15 | $1,148.15 |
BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $14,454.40 Typical High $21,877.62 | Facility | None | $10,232.93 | $14,454.40 | $21,877.62 |
BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,819.70 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $12,022.64 Typical High $15,135.61 | Facility | None | $776.25 | $12,022.64 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,318.26 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,230.27 | $1,819.70 | $4,365.16 |
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 $1,318.26 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,445.44 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $125.89 Typical High $1,258.93 | Professional | None | $33.11 | $125.89 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,258.93 | $2,187.76 |
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 $524.81 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $524.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $208.93 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $776.25 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $724.44 | $812.83 | $812.83 |
Where Illinois sits
The same service costs 8.3 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· 34th of 51
$1,318
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.