How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,259 to $12,303Professionalmedian $851 · 10th to 90th $589 to $1,202
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 $645.65 Median $2,137.96 Typical High $7,762.47 | Facility | None | $645.65 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $977.24 | Professional | None | $575.44 | $645.65 | $977.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,918.31 Median $9,120.11 Typical High $12,589.25 | Facility | None | $6,918.31 | $9,120.11 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,202.26 | Professional | None | $741.31 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,128.31 Typical High $10,471.29 | Facility | None | $741.31 | $8,128.31 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,122.02 | Professional | None | $691.83 | $870.96 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $2,754.23 | Professional | None | $676.08 | $1,023.29 | $2,754.23 |
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 $758.58 Median $794.33 Typical High $891.25 | Professional | None | $758.58 | $794.33 | $891.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $69.18 Typical High $707.95 | Professional | None | $33.11 | $69.18 | $707.95 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,128.61 | $15,848.93 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,258.93 | Professional | None | $562.34 | $707.95 | $1,258.93 |
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 $295.12 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $446.68 |
Where Illinois sits
The same service costs 6.8 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 $13,753MT $2,023
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.