How much rates vary
Facilitymedian $380 · 10th to 90th $178 to $3,236Professionalmedian $562 · 10th to 90th $447 to $912
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 $467.74 Median $1,380.38 Typical High $5,623.41 | Facility | None | $467.74 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $776.25 | Professional | None | $426.58 | $478.63 | $776.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $6,025.60 | Facility | None | $204.17 | $309.03 | $6,025.60 |
BCBS Illinois Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,096.48 | Professional | None | $562.34 | $776.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $275.42 Typical High $512.86 | Facility | None | $190.55 | $275.42 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $870.96 | Professional | None | $489.78 | $575.44 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,621.81 | Professional | None | $524.81 | $758.58 | $1,621.81 |
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 $588.84 Typical High $707.95 | Professional | None | $562.34 | $588.84 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $63.10 Typical High $630.96 | Professional | None | $33.11 | $63.10 | $630.96 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $912.01 | Professional | None | $436.52 | $524.81 | $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 $213.80 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $302.00 | $331.13 | $354.81 |
Where Illinois sits
The same service costs 4.7 times more in New York 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
NY $3,038FL $649
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.