How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,318 to $12,882Professionalmedian $1,905 · 10th to 90th $1,549 to $3,090
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 $3,235.94 Typical High $9,120.11 | Facility | None | $1,023.29 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,698.24 | $1,698.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $10,232.93 Typical High $21,877.62 | Facility | None | $7,413.10 | $10,232.93 | $21,877.62 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,090.30 | Professional | None | $1,949.84 | $2,630.27 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $8,709.64 Typical High $10,964.78 | Facility | None | $776.25 | $8,709.64 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,698.24 | $1,905.46 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $7,585.78 | Professional | None | $1,778.28 | $2,691.53 | $7,585.78 |
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 $1,905.46 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,905.46 | $2,089.30 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $1,995.26 | Professional | None | $33.11 | $181.97 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,548.82 | $1,905.46 | $3,311.31 |
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 $758.58 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 4.7 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 $16,761KY $3,604
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.