How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,288 to $11,220Professionalmedian $1,023 · 10th to 90th $759 to $1,585
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 $851.14 Median $3,235.94 Typical High $7,762.47 | Facility | None | $851.14 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | None | $758.58 | $851.14 | $851.14 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $12,882.50 | Facility | None | $5,495.41 | $8,317.64 | $12,882.50 |
BCBS Illinois Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,584.89 | Professional | None | $977.24 | $1,318.26 | $1,584.89 |
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 $891.25 Median $1,071.52 Typical High $1,445.44 | Professional | None | $891.25 | $1,071.52 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $3,467.37 | Professional | None | $891.25 | $1,348.96 | $3,467.37 |
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 $977.24 Median $1,047.13 Typical High $1,174.90 | Professional | None | $977.24 | $1,047.13 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $91.20 Typical High $933.25 | Professional | None | $33.11 | $91.20 | $933.25 |
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 $758.58 Median $933.25 Typical High $1,621.81 | Professional | None | $758.58 | $933.25 | $1,621.81 |
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 $380.19 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $588.84 |
Where Illinois sits
The same service costs 5.3 times more in Colorado 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
CO $14,031MT $2,637
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.