How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,047 to $12,303Professionalmedian $776 · 10th to 90th $603 to $1,259
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 $758.58 Median $2,630.27 Typical High $7,762.47 | Facility | None | $758.58 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $831.76 | Professional | None | $588.84 | $660.69 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $331.13 Typical High $363.08 | Professional | None | $45.71 | $331.13 | $363.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,762.47 Median $9,772.37 Typical High $12,882.50 | Facility | None | $7,762.47 | $9,772.37 | $12,882.50 |
BCBS Illinois Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $776.25 | $1,047.13 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $9,549.93 Typical High $12,302.69 | Facility | None | $891.25 | $9,549.93 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,148.15 | Professional | None | $676.08 | $794.33 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $3,311.31 | Professional | None | $707.95 | $1,047.13 | $3,311.31 |
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 $776.25 Median $831.76 Typical High $912.01 | Professional | None | $776.25 | $831.76 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $741.31 | Professional | None | $33.11 | $72.44 | $741.31 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,174.90 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,288.25 | Professional | None | $588.84 | $724.44 | $1,288.25 |
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 $302.00 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $467.74 |
Where Illinois sits
The same service costs 5.4 times more in Alaska 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
AK $11,142MT $2,070
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.