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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,659.59 | $2,041.74 |
BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $25,703.96 Typical High $51,286.14 | Facility | None | $12,022.64 | $25,703.96 | $51,286.14 |
BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $3,090.30 | Professional | None | $1,778.28 | $2,951.21 | $3,090.30 |
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 $1,778.28 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,778.28 | $1,862.09 | $3,019.95 |
Hally Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $7,762.47 | Professional | None | $1,659.59 | $2,570.40 | $7,762.47 |
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 $1,949.84 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,949.84 | $2,041.74 | $2,238.72 |
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 $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 $1,698.24 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,290.87 | $3,630.78 |
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 $831.76 Median $831.76 Typical High $933.25 | Professional | 52 · Reduced service | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 53 · Discontinued | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,318.26 |
Where Illinois sits
The same service costs 6.8 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
$1,995
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.