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 $2,454.71 Typical High $7,762.47 | Facility | None | $933.25 | $2,454.71 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,238.72 | $2,454.71 | $2,454.71 |
BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $26,915.35 Typical High $53,703.18 | Facility | None | $12,589.25 | $26,915.35 | $53,703.18 |
BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $4,265.80 | Professional | None | $2,818.38 | $3,311.31 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $4,365.16 | Professional | None | $2,137.96 | $3,019.95 | $4,365.16 |
Hally Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,467.37 Typical High $8,511.38 | Professional | None | $2,398.83 | $3,467.37 | $8,511.38 |
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 $2,630.27 Median $2,951.21 Typical High $3,311.31 | Professional | None | $2,630.27 | $2,951.21 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $323.59 | Professional | None | $33.11 | $33.11 | $323.59 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,570.40 | $4,570.88 |
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 $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $446.68 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,659.59 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $331.13 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,737.80 | $1,737.80 |
Where Illinois sits
The same service costs 20.9 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· 33rd of 51
$2,455
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.