How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,259 to $10,233Professionalmedian $912 · 10th to 90th $759 to $1,549
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 $870.96 Median $2,951.21 Typical High $7,762.47 | Facility | None | $870.96 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | None | $794.33 | $870.96 | $870.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $11,220.18 | Facility | None | $4,570.88 | $6,760.83 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,548.82 | Professional | None | $954.99 | $1,122.02 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $6,760.83 | Facility | None | $630.96 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,412.54 | Professional | None | $851.14 | $891.25 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $3,715.35 | Professional | None | $912.01 | $1,380.38 | $3,715.35 |
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 $1,023.29 Median $1,071.52 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,071.52 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $89.13 Typical High $912.01 | Professional | None | $33.11 | $89.13 | $912.01 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,698.24 | Professional | None | $776.25 | $977.24 | $1,698.24 |
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 $398.11 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $602.56 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $562.34 | $602.56 | $602.56 |
Where Illinois sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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 $10,228KY $2,649
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.