How much rates vary
Facilitymedian $2,570 · 10th to 90th $708 to $6,026Professionalmedian $708 · 10th to 90th $447 to $1,122
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 $549.54 Median $933.25 Typical High $5,495.41 | Facility | None | $549.54 | $933.25 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $977.24 | Professional | None | $407.38 | $524.81 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,454.71 | $3,548.13 | $6,918.31 |
BCBS Illinois Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,122.02 | Professional | None | $588.84 | $794.33 | $1,122.02 |
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 $436.52 Median $707.95 Typical High $1,071.52 | Professional | None | $436.52 | $707.95 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,584.89 | Professional | None | $512.86 | $812.83 | $1,584.89 |
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 $537.03 Median $602.56 Typical High $812.83 | Professional | None | $537.03 | $602.56 | $812.83 |
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 $7,079.46 | Facility | None | $1,047.13 | $2,454.71 | $7,079.46 |
United Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,174.90 | Professional | None | $446.68 | $645.65 | $1,174.90 |
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 $204.17 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $204.17 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $309.03 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $61.66 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $288.40 | $331.13 | $389.05 |
Where Illinois sits
The same service costs 4.7 times more in Vermont than in Montana. 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 $7,643MT $1,633
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.