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 $758.58 Median $3,235.94 Typical High $9,332.54 | Facility | None | $758.58 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $870.96 | Professional | None | $588.84 | $588.84 | $870.96 |
BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,128.61 Typical High $9,332.54 | Facility | None | $3,467.37 | $5,128.61 | $9,332.54 |
BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,122.02 | Professional | None | $707.95 | $1,071.52 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,073.80 Typical High $5,128.61 | Facility | None | $776.25 | $4,073.80 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $1,096.48 | Professional | None | $630.96 | $676.08 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,698.24 | Professional | None | $588.84 | $933.25 | $1,698.24 |
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 $741.31 Typical High $794.33 | Professional | None | $691.83 | $741.31 | $794.33 |
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 $1,288.25 Median $4,073.80 Typical High $11,748.98 | Facility | None | $1,288.25 | $4,073.80 | $11,748.98 |
United Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,288.25 | Professional | None | $602.56 | $812.83 | $1,288.25 |
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 $295.12 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $467.74 |
Where Illinois sits
The same service costs 9.8 times more in Oklahoma than in Utah. 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· 24th of 51
$933
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.