How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $5,623Professionalmedian $1,072 · 10th to 90th $759 to $1,514
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 $758.58 Median $1,348.96 Typical High $5,623.41 | Facility | None | $758.58 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,412.54 | Professional | None | $676.08 | $758.58 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,348.96 | Professional | None | $758.58 | $1,000.00 | $1,348.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,951.21 Median $4,365.16 Typical High $8,912.51 | Facility | None | $2,951.21 | $4,365.16 | $8,912.51 |
BCBS Illinois Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,348.96 | Professional | None | $933.25 | $1,122.02 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,467.37 Typical High $4,365.16 | Facility | None | $630.96 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,479.11 | Professional | None | $794.33 | $1,047.13 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,511.89 | Professional | None | $794.33 | $1,230.27 | $2,511.89 |
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 $933.25 Median $1,000.00 Typical High $1,122.02 | Professional | None | $933.25 | $1,000.00 | $1,122.02 |
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 $4,677.35 | Facility | None | $676.08 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,737.80 | Professional | None | $724.44 | $1,023.29 | $1,737.80 |
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 $338.84 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $549.54 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Georgia. 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.
Physician feeFacility fee
AK $7,038GA $2,000
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.