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 $35.48 Median $1,122.02 Typical High $5,888.44 | Facility | None | $35.48 | $1,122.02 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $58.88 | Professional | None | $30.20 | $44.67 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
BCBS Setting Facility Modifier None Typical Low $128.82 Median $204.17 Typical High $707.95 | Facility | None | $128.82 | $204.17 | $707.95 |
BCBS Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $95.50 | Professional | None | $33.11 | $54.95 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $776.25 Typical High $2,691.53 | Facility | None | $501.19 | $776.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Hally Health Setting Professional Modifier None Typical Low $31.62 Median $53.70 Typical High $125.89 | Professional | None | $31.62 | $53.70 | $125.89 |
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 $38.02 Median $41.69 Typical High $70.79 | Professional | None | $38.02 | $41.69 | $70.79 |
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 $138.04 Median $457.09 Typical High $1,949.84 | Facility | None | $138.04 | $457.09 | $1,949.84 |
United Setting Professional Modifier None Typical Low $33.88 Median $54.95 Typical High $93.33 | Professional | None | $33.88 | $54.95 | $93.33 |
5 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 $16.60 Median $17.78 Typical High $27.54 | Professional | 52 · Reduced service | $16.60 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.08 Typical High $10.96 | Professional | 53 · Discontinued | $6.61 | $7.08 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $26.92 Typical High $41.69 | Professional | 54 · Surgery only | $25.12 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.37 Typical High $8.32 | Professional | 55 · Aftercare only | $5.01 | $5.37 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.55 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.31 | $3.55 | $5.50 |
Where Illinois sits
The same service costs 2.8 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· 23rd of 51
$54.95
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.