How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,349 to $11,749Professionalmedian $4,571 · 10th to 90th $525 to $9,333
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 $758.58 Median $3,715.35 Typical High $9,772.37 | Facility | None | $758.58 | $3,715.35 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $4,265.80 Typical High $7,413.10 | Professional | None | $489.78 | $4,265.80 | $7,413.10 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $794.33 | Professional | None | $288.40 | $549.54 | $794.33 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $7,413.10 Typical High $11,481.54 | Facility | None | $5,495.41 | $7,413.10 | $11,481.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $588.84 Median $1,621.81 Typical High $10,715.19 | Professional | None | $588.84 | $1,621.81 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,606.93 Typical High $8,317.64 | Facility | None | $776.25 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,318.26 Typical High $8,912.51 | Professional | None | $602.56 | $1,318.26 | $8,912.51 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $6,760.83 Typical High $10,000.00 | Professional | None | $691.83 | $6,760.83 | $10,000.00 |
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 $588.84 Median $645.65 Typical High $6,918.31 | Professional | None | $588.84 | $645.65 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $5,011.87 | Professional | None | $33.11 | $33.11 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $562.34 Median $4,786.30 Typical High $10,964.78 | Professional | None | $562.34 | $4,786.30 | $10,964.78 |
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 $239.88 Median $2,089.30 Typical High $2,818.38 | Professional | 52 · Reduced service | $239.88 | $2,089.30 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $831.76 Typical High $1,122.02 | Professional | 53 · Discontinued | $97.72 | $831.76 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $3,090.30 Typical High $4,168.69 | Professional | 54 · Surgery only | $371.54 | $3,090.30 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $616.60 Typical High $831.76 | Professional | 55 · Aftercare only | $72.44 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $416.87 Typical High $562.34 | Professional | 56 · Pre-op care only | $47.86 | $416.87 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $2,884.03 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $338.84 | $2,884.03 | $3,890.45 |
Where Illinois sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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
OK $20,151MS $3,493
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.