How much rates vary
Facilitymedian $355 · 10th to 90th $174 to $2,138Professionalmedian $347 · 10th to 90th $245 to $603
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 $295.12 Median $537.03 Typical High $4,677.35 | Facility | None | $295.12 | $537.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $524.81 | Professional | None | $245.47 | $275.42 | $524.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $3,548.13 | Facility | None | $204.17 | $309.03 | $3,548.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $707.95 | Professional | None | $380.19 | $512.86 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $363.08 | Facility | None | $141.25 | $251.19 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $562.34 | Professional | None | $245.47 | $346.74 | $562.34 |
Hally Health Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $1,047.13 | Professional | None | $288.40 | $446.68 | $1,047.13 |
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 $323.59 Median $346.74 Typical High $416.87 | Professional | None | $323.59 | $346.74 | $416.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $416.87 | Professional | None | $33.11 | $41.69 | $416.87 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $524.81 | Professional | None | $234.42 | $288.40 | $524.81 |
7 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 $123.03 Median $134.90 Typical High $147.91 | Professional | 52 · Reduced service | $123.03 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $173.78 | $190.55 | $208.93 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $158.49 | $158.49 | $186.21 |
Where Illinois sits
The same service costs 6.4 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 $2,602FL $408
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.