How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,148 to $7,762Professionalmedian $1,288 · 10th to 90th $646 to $2,399
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 $933.25 Median $1,905.46 Typical High $5,623.41 | Facility | None | $933.25 | $1,905.46 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,288.25 | $1,288.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $16,595.87 | Facility | None | $2,511.89 | $3,981.07 | $16,595.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,479.11 | $2,041.74 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,884.03 Typical High $3,715.35 | Facility | None | $630.96 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $2,041.74 | Professional | None | $660.69 | $1,047.13 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,995.26 Typical High $5,495.41 | Professional | None | $891.25 | $1,995.26 | $5,495.41 |
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 $1,479.11 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,621.81 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $1,412.54 | Professional | None | $33.11 | $138.04 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,148.15 Typical High $2,454.71 | Professional | None | $645.65 | $1,148.15 | $2,454.71 |
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 $575.44 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $891.25 |
Where Illinois sits
The same service costs 3.7 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 $9,494KY $2,537
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.