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 $186.21 Median $1,288.25 Typical High $5,623.41 | Facility | None | $186.21 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $489.78 | Professional | None | $158.49 | $269.15 | $489.78 |
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 $309.03 Median $501.19 Typical High $1,995.26 | Facility | None | $309.03 | $501.19 | $1,995.26 |
BCBS Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $489.78 | Professional | None | $162.18 | $295.12 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $549.54 | Facility | None | $288.40 | $407.38 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $501.19 | Professional | None | $147.91 | $288.40 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $707.95 | Professional | None | $162.18 | $346.74 | $707.95 |
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 $186.21 Median $190.55 Typical High $354.81 | Professional | None | $186.21 | $190.55 | $354.81 |
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 $676.08 Median $1,513.56 Typical High $4,073.80 | Facility | None | $676.08 | $1,513.56 | $4,073.80 |
United Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $537.03 | Professional | None | $162.18 | $281.84 | $537.03 |
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 $77.62 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $77.62 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $31.62 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $117.49 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $23.44 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.49 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $109.65 | $186.21 | $218.78 |
Where Illinois sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 19th of 51
$309
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.