How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,175 to $10,471Professionalmedian $933 · 10th to 90th $617 to $1,318
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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $724.44 | Professional | None | $616.60 | $676.08 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $7,943.28 Typical High $12,589.25 | Facility | None | $5,495.41 | $7,943.28 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,348.96 | Professional | None | $831.76 | $1,122.02 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,456.54 Typical High $8,317.64 | Facility | None | $891.25 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,202.26 | Professional | None | $758.58 | $1,096.48 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,951.21 | Professional | None | $758.58 | $1,148.15 | $2,951.21 |
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 $812.83 Median $891.25 Typical High $977.24 | Professional | None | $812.83 | $891.25 | $977.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $77.62 Typical High $794.33 | Professional | None | $33.11 | $77.62 | $794.33 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $10,471.29 | Facility | None | $1,174.90 | $3,090.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,380.38 | Professional | None | $616.60 | $758.58 | $1,380.38 |
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 $309.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Where Illinois sits
The same service costs 4.8 times more in Alaska than in Montana. 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 $10,454MT $2,169
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.