How much rates vary
Facilitymedian $1,413 · 10th to 90th $550 to $4,169Professionalmedian $661 · 10th to 90th $513 to $1,096
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 $562.34 Median $977.24 Typical High $5,495.41 | Facility | None | $562.34 | $977.24 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $1,023.29 | Professional | None | $501.19 | $562.34 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $575.44 Typical High $602.56 | Professional | None | $281.84 | $575.44 | $602.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $6,918.31 | Facility | None | $1,318.26 | $2,041.74 | $6,918.31 |
BCBS Illinois Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,258.93 | Professional | None | $691.83 | $933.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,089.30 | Facility | None | $741.31 | $1,584.89 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,023.29 | Professional | None | $537.03 | $645.65 | $1,023.29 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,862.09 | Professional | None | $588.84 | $831.76 | $1,862.09 |
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 $616.60 Median $660.69 Typical High $776.25 | Professional | None | $616.60 | $660.69 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $741.31 | Professional | None | $33.11 | $72.44 | $741.31 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,801.89 | Facility | None | $446.68 | $1,047.13 | $3,801.89 |
United Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,047.13 | Professional | None | $478.63 | $616.60 | $1,047.13 |
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 $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $389.05 |
Where Illinois sits
The same service costs 4.0 times more in Colorado 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
CO $4,440FL $1,118
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.