How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,349 to $13,490Professionalmedian $1,413 · 10th to 90th $1,047 to $2,138
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 $9,332.54 | Facility | None | $1,023.29 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,148.15 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $9,772.37 Typical High $15,135.61 | Facility | None | $7,413.10 | $9,772.37 | $15,135.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,819.70 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $8,912.51 Typical High $11,220.18 | Facility | None | $776.25 | $8,912.51 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,445.44 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,230.27 | $1,819.70 | $4,570.88 |
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 $1,318.26 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,445.44 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $125.89 Typical High $1,318.26 | Professional | None | $33.11 | $125.89 | $1,318.26 |
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 $1,047.13 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,288.25 | $2,344.23 |
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 $524.81 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $524.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $776.25 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $724.44 | $812.83 | $812.83 |
Where Illinois sits
The same service costs 5.1 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 $14,343KY $2,808
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.