How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $4,169Professionalmedian $513 · 10th to 90th $389 to $832
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 $446.68 Median $1,737.80 Typical High $5,623.41 | Facility | None | $446.68 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $446.68 | Professional | None | $371.54 | $407.38 | $446.68 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $5,370.32 | Facility | None | $1,318.26 | $2,041.74 | $5,370.32 |
BCBS Illinois Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,000.00 | Professional | None | $512.86 | $707.95 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,584.89 Typical High $1,995.26 | Facility | None | $630.96 | $1,584.89 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $794.33 | Professional | None | $446.68 | $537.03 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $1,348.96 | Professional | None | $457.09 | $676.08 | $1,348.96 |
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 $489.78 Median $512.86 Typical High $630.96 | Professional | None | $489.78 | $512.86 | $630.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $57.54 Typical High $616.60 | Professional | None | $33.11 | $57.54 | $616.60 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,801.89 | Facility | None | $446.68 | $1,047.13 | $3,801.89 |
United Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $812.83 | Professional | None | $380.19 | $457.09 | $812.83 |
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 $186.21 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $74.13 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Where Illinois sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.