How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $11,220Professionalmedian $4,365 · 10th to 90th $490 to $9,120
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 $588.84 Median $3,715.35 Typical High $9,772.37 | Facility | None | $588.84 | $3,715.35 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $4,168.69 Typical High $7,244.36 | Professional | None | $467.74 | $4,168.69 | $7,244.36 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $4,897.79 Typical High $5,128.61 | Professional | None | $416.87 | $4,897.79 | $5,128.61 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $7,244.36 Typical High $11,220.18 | Facility | None | $5,495.41 | $7,244.36 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $549.54 Median $1,513.56 Typical High $10,715.19 | Professional | None | $549.54 | $1,513.56 | $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 $562.34 Median $1,230.27 Typical High $8,709.64 | Professional | None | $562.34 | $1,230.27 | $8,709.64 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $5,888.44 Typical High $9,549.93 | Professional | None | $645.65 | $5,888.44 | $9,549.93 |
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 $549.54 Median $602.56 Typical High $6,918.31 | Professional | None | $549.54 | $602.56 | $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 $5,370.32 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,370.32 | $15,488.17 |
United Setting Professional Modifier None Typical Low $524.81 Median $4,786.30 Typical High $10,964.78 | Professional | None | $524.81 | $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 $223.87 Median $2,041.74 Typical High $2,754.23 | Professional | 52 · Reduced service | $223.87 | $2,041.74 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $831.76 Typical High $1,096.48 | Professional | 53 · Discontinued | $91.20 | $831.76 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $3,090.30 Typical High $4,168.69 | Professional | 54 · Surgery only | $346.74 | $3,090.30 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $616.60 Typical High $831.76 | Professional | 55 · Aftercare only | $67.61 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $407.38 Typical High $549.54 | Professional | 56 · Pre-op care only | $45.71 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $2,884.03 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $316.23 | $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 $3,466
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.