How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,072 to $12,589Professionalmedian $851 · 10th to 90th $661 to $1,349
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 $660.69 Median $1,862.09 Typical High $7,079.46 | Facility | None | $660.69 | $1,862.09 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,096.48 | Professional | None | $588.84 | $707.95 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $691.83 Typical High $724.44 | Professional | None | $87.10 | $691.83 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,244.36 Median $9,332.54 Typical High $13,182.57 | Facility | None | $7,244.36 | $9,332.54 | $13,182.57 |
BCBS Illinois Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,348.96 | Professional | None | $831.76 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,511.38 Typical High $10,964.78 | Facility | None | $741.31 | $8,511.38 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,258.93 | Professional | None | $741.31 | $870.96 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $4,265.80 | Professional | None | $776.25 | $1,148.15 | $4,265.80 |
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 $851.14 Median $912.01 Typical High $1,000.00 | Professional | None | $851.14 | $912.01 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $77.62 Typical High $831.76 | Professional | None | $33.11 | $77.62 | $831.76 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,248.07 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,248.07 | $15,848.93 |
United Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,445.44 | Professional | None | $660.69 | $812.83 | $1,445.44 |
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 $331.13 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $512.86 |
Where Illinois sits
The same service costs 6.1 times more in Colorado 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
CO $13,882MT $2,270
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.