How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,413 to $13,804Professionalmedian $1,660 · 10th to 90th $1,148 to $2,884
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 $1,023.29 Median $3,388.44 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,388.44 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,548.82 | $1,548.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,709.64 Typical High $19,952.62 | Facility | None | $5,623.41 | $8,709.64 | $19,952.62 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $2,884.03 | Professional | None | $1,778.28 | $2,398.83 | $2,884.03 |
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 $1,148.15 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,479.11 | $2,511.89 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $5,754.40 | Professional | None | $1,380.38 | $2,344.23 | $5,754.40 |
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 $1,737.80 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,737.80 | $1,905.46 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $1,698.24 | Professional | None | $33.11 | $165.96 | $1,698.24 |
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 $1,096.48 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,659.59 | $2,951.21 |
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 $691.83 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,071.52 |
Where Illinois sits
The same service costs 5.5 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 $15,938KY $2,890
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.