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 $2,630.27 Typical High $7,762.47 | Facility | None | $933.25 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,630.27 | $2,884.03 |
BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $33,884.42 Typical High $67,608.30 | Facility | None | $15,848.93 | $33,884.42 | $67,608.30 |
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 $2,630.27 Median $3,467.37 Typical High $4,897.79 | Professional | None | $2,630.27 | $3,467.37 | $4,897.79 |
Hally Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,981.07 Typical High $8,128.31 | Professional | None | $2,454.71 | $3,981.07 | $8,128.31 |
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 $3,235.94 Typical High $3,715.35 | Professional | None | $2,630.27 | $3,235.94 | $3,715.35 |
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 $2,511.89 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,511.89 | $3,801.89 | $5,623.41 |
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 $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,096.48 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,621.81 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $323.59 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,862.09 | $1,862.09 |
Where Illinois sits
The same service costs 16.2 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· 27th of 51
$3,020
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.