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 $177.83 Median $1,318.26 Typical High $5,623.41 | Facility | None | $177.83 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $177.83 | Professional | None | $109.65 | $162.18 | $177.83 |
BCBS Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $1,202.26 | Facility | None | $190.55 | $309.03 | $1,202.26 |
BCBS Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $251.19 | Professional | None | $117.49 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $239.88 Typical High $338.84 | Facility | None | $131.83 | $239.88 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $275.42 | Professional | None | $104.71 | $144.54 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $338.84 | Professional | None | $128.82 | $218.78 | $338.84 |
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 $134.90 Typical High $234.42 | Professional | None | $131.83 | $134.90 | $234.42 |
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 $501.19 Typical High $1,862.09 | Facility | None | $141.25 | $501.19 | $1,862.09 |
United Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $309.03 | Professional | None | $112.20 | $173.78 | $309.03 |
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 $54.95 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $54.95 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $21.88 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $123.03 Typical High $134.90 | Professional | 54 · Surgery only | $83.18 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $26.92 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $114.82 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $77.62 | $114.82 | $125.89 |
Where Illinois sits
The same service costs 3.5 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· 33rd 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.