How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,122 to $7,413Professionalmedian $794 · 10th to 90th $525 to $1,096
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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | None | $524.81 | $575.44 | $575.44 |
BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $7,413.10 | Facility | None | $2,511.89 | $3,630.78 | $7,413.10 |
BCBS Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,096.48 | Professional | None | $676.08 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,715.35 | Facility | None | $741.31 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,047.13 | Professional | None | $630.96 | $954.99 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $2,454.71 | Professional | None | $616.60 | $977.24 | $2,454.71 |
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 $676.08 Median $724.44 Typical High $794.33 | Professional | None | $676.08 | $724.44 | $794.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $63.10 Typical High $660.69 | Professional | None | $33.11 | $63.10 | $660.69 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,148.15 | Professional | None | $512.86 | $660.69 | $1,148.15 |
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 $263.03 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $407.38 |
Where Illinois sits
The same service costs 4.1 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $7,594MT $1,845
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.