How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,259 to $19,055Professionalmedian $1,585 · 10th to 90th $1,096 to $2,754
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 $977.24 Median $2,454.71 Typical High $9,120.11 | Facility | None | $977.24 | $2,454.71 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,096.48 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $1,548.82 Typical High $1,548.82 | Professional | None | $186.21 | $1,548.82 | $1,548.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,760.83 Median $10,232.93 Typical High $21,877.62 | Facility | None | $6,760.83 | $10,232.93 | $21,877.62 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,584.89 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $8,128.31 Typical High $10,471.29 | Facility | None | $1,023.29 | $8,128.31 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,548.82 | $2,511.89 |
Hally Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,370.32 | Professional | None | $1,174.90 | $1,862.09 | $5,370.32 |
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 $1,380.38 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,445.44 | $1,621.81 |
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 $1,479.11 Median $5,248.07 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,248.07 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,380.38 | $1,905.46 | $3,235.94 |
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 $489.78 Median $549.54 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $741.31 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $812.83 |
Where Illinois sits
The same service costs 6.3 times more in Wyoming 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
WY $21,505HI $3,422
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.