How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,047 to $6,166Professionalmedian $617 · 10th to 90th $447 to $891
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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $512.86 | Professional | None | $446.68 | $489.78 | $512.86 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $6,309.57 | Facility | None | $2,511.89 | $3,630.78 | $6,309.57 |
BCBS Illinois Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $891.25 | Professional | None | $549.54 | $758.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,715.35 | Facility | None | $741.31 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $831.76 | Professional | None | $524.81 | $645.65 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $2,630.27 | Professional | None | $512.86 | $776.25 | $2,630.27 |
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 $562.34 Median $602.56 Typical High $676.08 | Professional | None | $562.34 | $602.56 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $524.81 | Professional | None | $33.11 | $52.48 | $524.81 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $912.01 | Professional | None | $426.58 | $537.03 | $912.01 |
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 $223.87 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $309.03 | $338.84 | $338.84 |
Where Illinois sits
The same service costs 4.6 times more in Alabama 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
AL $7,006MT $1,517
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.