How much rates vary
Facilitymedian $2,570 · 10th to 90th $631 to $5,888Professionalmedian $631 · 10th to 90th $407 to $1,023
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 $489.78 Median $794.33 Typical High $5,495.41 | Facility | None | $489.78 | $794.33 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $891.25 | Professional | None | $363.08 | $501.19 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $562.34 | Professional | None | $316.23 | $501.19 | $562.34 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $6,760.83 | Facility | None | $2,398.83 | $3,548.13 | $6,760.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,023.29 | Professional | None | $537.03 | $724.44 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $3,630.78 | Facility | None | $741.31 | $2,818.38 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $977.24 | Professional | None | $407.38 | $630.96 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,380.38 | Professional | None | $457.09 | $741.31 | $1,380.38 |
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 $489.78 Median $537.03 Typical High $741.31 | Professional | None | $489.78 | $537.03 | $741.31 |
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 $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $1,047.13 | Professional | None | $407.38 | $575.44 | $1,047.13 |
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 $181.97 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $74.13 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $275.42 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $257.04 | $302.00 | $346.74 |
Where Illinois sits
The same service costs 7.2 times more in Vermont than in Maine. 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
VT $9,370ME $1,294
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.