How much rates vary
Facilitymedian $1,380 · 10th to 90th $209 to $3,715Professionalmedian $525 · 10th to 90th $389 to $871
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 $436.52 Median $1,380.38 Typical High $5,623.41 | Facility | None | $436.52 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $676.08 | Professional | None | $398.11 | $436.52 | $676.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $5,623.41 | Facility | None | $1,318.26 | $2,041.74 | $5,623.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,023.29 | Professional | None | $524.81 | $707.95 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $1,949.84 | Facility | None | $478.63 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $794.33 | Professional | None | $389.05 | $524.81 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,412.54 | Professional | None | $467.74 | $707.95 | $1,412.54 |
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 $524.81 Median $549.54 Typical High $660.69 | Professional | None | $524.81 | $549.54 | $660.69 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $58.88 Typical High $602.56 | Professional | None | $33.11 | $58.88 | $602.56 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $2,818.38 | Facility | None | $141.25 | $501.19 | $2,818.38 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $851.14 | Professional | None | $380.19 | $478.63 | $851.14 |
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 $199.53 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $79.43 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $331.13 |
Where Illinois sits
The same service costs 5.3 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 $4,377FL $831
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.