How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,230 to $8,913Professionalmedian $1,023 · 10th to 90th $759 to $1,660
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 $794.33 Median $2,137.96 Typical High $7,762.47 | Facility | None | $794.33 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $912.01 | Professional | None | $794.33 | $870.96 | $912.01 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $11,481.54 | Facility | None | $2,511.89 | $3,981.07 | $11,481.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,380.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,348.96 | $2,818.38 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $3,548.13 | Professional | None | $912.01 | $1,412.54 | $3,548.13 |
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 $1,023.29 Median $1,071.52 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,071.52 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $95.50 Typical High $977.24 | Professional | None | $33.11 | $95.50 | $977.24 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,698.24 | Professional | None | $758.58 | $954.99 | $1,698.24 |
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 $398.11 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $616.60 |
Where Illinois sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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
WI $8,857KS $2,587
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.