How much rates vary
Facilitymedian $3,631 · 10th to 90th $955 to $8,511Professionalmedian $646 · 10th to 90th $525 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 $630.96 Median $1,513.56 Typical High $7,079.46 | Facility | None | $630.96 | $1,513.56 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $891.25 | Professional | None | $524.81 | $588.84 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $977.24 | Professional | None | $537.03 | $812.83 | $977.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $7,585.78 | Facility | None | $2,511.89 | $3,630.78 | $7,585.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,096.48 | Professional | None | $676.08 | $933.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,019.95 Typical High $3,715.35 | Facility | None | $891.25 | $3,019.95 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $977.24 | Professional | None | $575.44 | $616.60 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $2,238.72 | Professional | None | $616.60 | $933.25 | $2,238.72 |
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 $691.83 Median $741.31 Typical High $812.83 | Professional | None | $691.83 | $741.31 | $812.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $64.57 Typical High $645.65 | Professional | None | $33.11 | $64.57 | $645.65 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $12,882.50 | Facility | None | $1,479.11 | $5,011.87 | $12,882.50 |
United Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $1,096.48 | Professional | None | $524.81 | $616.60 | $1,096.48 |
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 $269.15 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $407.38 |
Where Illinois sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.