How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,148 to $11,220Professionalmedian $955 · 10th to 90th $631 to $1,288
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 $630.96 Median $1,949.84 Typical High $6,165.95 | Facility | None | $630.96 | $1,949.84 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $724.44 | Professional | None | $630.96 | $691.83 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,120.11 Typical High $12,589.25 | Facility | None | $7,079.46 | $9,120.11 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,288.25 | Professional | None | $794.33 | $1,071.52 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,317.64 Typical High $10,715.19 | Facility | None | $741.31 | $8,317.64 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,174.90 | Professional | None | $741.31 | $1,122.02 | $1,174.90 |
Hally Health Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $2,951.21 | Professional | None | $741.31 | $1,148.15 | $2,951.21 |
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 $812.83 Median $870.96 Typical High $954.99 | Professional | None | $812.83 | $870.96 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $74.13 Typical High $758.58 | Professional | None | $33.11 | $74.13 | $758.58 |
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 $616.60 Median $794.33 Typical High $1,380.38 | Professional | None | $616.60 | $794.33 | $1,380.38 |
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 $316.23 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $478.63 |
Where Illinois sits
The same service costs 6.4 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 $13,837MT $2,168
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.