How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,072 to $18,621Professionalmedian $1,862 · 10th to 90th $1,479 to $3,020
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 $831.76 Median $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,621.81 | $1,621.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,232.93 Median $15,135.61 Typical High $23,442.29 | Facility | None | $10,232.93 | $15,135.61 | $23,442.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,511.89 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $12,022.64 Typical High $15,135.61 | Facility | None | $776.25 | $12,022.64 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,698.24 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $8,128.31 | Professional | None | $1,737.80 | $2,570.40 | $8,128.31 |
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 $1,862.09 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,862.09 | $2,041.74 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $1,778.28 | Professional | None | $33.11 | $173.78 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,398.83 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,819.70 | $3,235.94 |
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 $741.31 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,148.15 |
Where Illinois sits
The same service costs 6.3 times more in Alaska than in Texas. 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 $16,928TX $2,675
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.