How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,318 to $12,303Professionalmedian $1,479 · 10th to 90th $1,175 to $2,455
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 $1,202.26 Median $2,187.76 Typical High $8,128.31 | Facility | None | $1,202.26 | $2,187.76 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,318.26 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $16,982.44 | Facility | None | $5,623.41 | $8,317.64 | $16,982.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,513.56 | $2,041.74 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $6,606.93 Typical High $8,317.64 | Facility | None | $1,023.29 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,445.44 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $7,079.46 | Professional | None | $1,380.38 | $2,089.30 | $7,079.46 |
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 $1,513.56 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,621.81 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $141.25 Typical High $1,445.44 | Professional | None | $33.11 | $141.25 | $1,445.44 |
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 $1,174.90 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,479.11 | $2,570.40 |
7 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 $588.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $912.01 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 59 · Distinct service | $1,174.90 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.