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 $2,398.83 Typical High $7,762.47 | Facility | None | $933.25 | $2,398.83 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,398.83 | $2,754.23 |
BCBS Setting Facility Modifier None Typical Low $14,454.40 Median $30,902.95 Typical High $61,659.50 | Facility | None | $14,454.40 | $30,902.95 | $61,659.50 |
BCBS Setting Professional Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $6,606.93 | Professional | None | $3,467.37 | $3,890.45 | $6,606.93 |
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 $2,290.87 Median $3,162.28 Typical High $4,677.35 | Professional | None | $2,290.87 | $3,162.28 | $4,677.35 |
Hally Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,630.78 Typical High $7,413.10 | Professional | None | $2,238.72 | $3,630.78 | $7,413.10 |
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 $2,398.83 Median $2,951.21 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,951.21 | $3,388.44 |
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 $2,290.87 Median $3,388.44 Typical High $5,128.61 | Professional | None | $2,290.87 | $3,388.44 | $5,128.61 |
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 $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $977.24 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,479.11 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $295.12 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,698.24 | $1,698.24 |
Where Illinois sits
The same service costs 7.2 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· 26th of 51
$2,754
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.