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 $147.91 Median $1,288.25 Typical High $5,623.41 | Facility | None | $147.91 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $181.97 | Professional | None | $112.20 | $144.54 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $2,344.23 | Facility | None | $151.36 | $245.47 | $2,344.23 |
BCBS Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $223.87 | Professional | None | $120.23 | $173.78 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $204.17 Typical High $512.86 | Facility | None | $141.25 | $204.17 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $239.88 | Professional | None | $134.90 | $169.82 | $239.88 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $467.74 | Professional | None | $125.89 | $190.55 | $467.74 |
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 $131.83 Median $138.04 Typical High $194.98 | Professional | None | $131.83 | $138.04 | $194.98 |
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 $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $263.03 | Professional | None | $112.20 | $154.88 | $263.03 |
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 $56.23 Median $67.61 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $29.51 | Professional | 53 · Discontinued | $22.39 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $112.20 | Professional | 54 · Surgery only | $83.18 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $22.39 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $95.50 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $77.62 | $95.50 | $104.71 |
Where Illinois sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 28th of 51
$162
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.