How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,047 to $10,715Professionalmedian $851 · 10th to 90th $676 to $1,445
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 $707.95 Median $1,258.93 Typical High $5,623.41 | Facility | None | $707.95 | $1,258.93 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,148.15 | Professional | None | $691.83 | $758.58 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $12,589.25 | Facility | None | $5,495.41 | $8,317.64 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,445.44 | Professional | None | $891.25 | $1,202.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,456.54 Typical High $8,317.64 | Facility | None | $741.31 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,288.25 | Professional | None | $691.83 | $776.25 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $3,019.95 | Professional | None | $794.33 | $1,202.26 | $3,019.95 |
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 $891.25 Median $954.99 Typical High $1,071.52 | Professional | None | $891.25 | $954.99 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $83.18 Typical High $851.14 | Professional | None | $33.11 | $83.18 | $851.14 |
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 $676.08 Median $812.83 Typical High $1,479.11 | Professional | None | $676.08 | $812.83 | $1,479.11 |
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 $346.74 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $537.03 |
Where Illinois sits
The same service costs 5.6 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 $13,636HI $2,423
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.