How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,175 to $7,244Professionalmedian $661 · 10th to 90th $562 to $1,122
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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | None | $575.44 | $630.96 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $6,918.31 | Facility | None | $2,630.27 | $3,890.45 | $6,918.31 |
BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,096.48 | Professional | None | $724.44 | $851.14 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $3,890.45 | Facility | None | $891.25 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,995.26 | Professional | None | $616.60 | $912.01 | $1,995.26 |
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 $691.83 Median $776.25 Typical High $851.14 | Professional | None | $691.83 | $776.25 | $851.14 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $58.88 | Professional | None | $33.11 | $33.11 | $58.88 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,511.38 | Facility | None | $1,174.90 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,148.15 | Professional | None | $575.44 | $691.83 | $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 $288.40 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $446.68 |
Where Illinois sits
The same service costs 4.0 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 $7,771MT $1,932
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.