How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,096 to $12,023Professionalmedian $1,047 · 10th to 90th $537 to $1,820
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 $630.96 Median $1,819.70 Typical High $5,888.44 | Facility | None | $630.96 | $1,819.70 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,148.15 | Professional | None | $645.65 | $724.44 | $1,148.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,786.30 Median $7,079.46 Typical High $14,125.38 | Facility | None | $4,786.30 | $7,079.46 | $14,125.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $891.25 | $1,047.13 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,623.41 Typical High $7,244.36 | Facility | None | $630.96 | $5,623.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $977.24 Typical High $1,479.11 | Professional | None | $457.09 | $977.24 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $1,174.90 Typical High $4,265.80 | Professional | None | $588.84 | $1,174.90 | $4,265.80 |
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 $891.25 Median $954.99 Typical High $1,071.52 | Professional | None | $891.25 | $954.99 | $1,071.52 |
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 $1,288.25 Median $4,168.69 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,168.69 | $12,882.50 |
United Setting Professional Modifier None Typical Low $562.34 Median $1,096.48 Typical High $2,137.96 | Professional | None | $562.34 | $1,096.48 | $2,137.96 |
7 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 $323.59 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $537.03 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 50 · Both sides | $478.63 | $478.63 | $478.63 |
Where Illinois sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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
CO $12,924HI $2,150
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.