How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,413 to $14,125Professionalmedian $2,291 · 10th to 90th $1,288 to $3,890
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 $1,023.29 Median $3,388.44 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,388.44 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,905.46 | $2,089.30 | $2,089.30 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,912.51 Typical High $27,542.29 | Facility | None | $5,623.41 | $8,912.51 | $27,542.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $3,890.45 | Professional | None | $2,398.83 | $3,235.94 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,606.93 Typical High $8,317.64 | Facility | None | $776.25 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,905.46 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $1,621.81 Median $3,235.94 Typical High $7,943.28 | Professional | None | $1,621.81 | $3,235.94 | $7,943.28 |
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 $2,398.83 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,630.27 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $2,290.87 | Professional | None | $33.11 | $223.87 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $4,073.80 | Professional | None | $1,288.25 | $2,290.87 | $4,073.80 |
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 $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $954.99 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,412.54 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,479.11 | $1,479.11 |
Where Illinois sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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
AK $18,090KY $3,723
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.