How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,514 to $12,589Professionalmedian $1,072 · 10th to 90th $759 to $1,549
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 $1,905.46 Typical High $7,762.47 | Facility | None | $758.58 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,258.93 | Professional | None | $741.31 | $831.76 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $10,715.19 | Facility | None | $2,511.89 | $3,981.07 | $10,715.19 |
BCBS Illinois Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,548.82 | Professional | None | $977.24 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,884.03 Typical High $3,715.35 | Facility | None | $776.25 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,412.54 | Professional | None | $870.96 | $1,096.48 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $3,235.94 | Professional | None | $851.14 | $1,288.25 | $3,235.94 |
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 $891.25 Median $1,023.29 Typical High $1,122.02 | Professional | None | $891.25 | $1,023.29 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $91.20 Typical High $933.25 | Professional | None | $33.11 | $91.20 | $933.25 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $7,585.78 Typical High $16,595.87 | Facility | None | $1,659.59 | $7,585.78 | $16,595.87 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,659.59 | Professional | None | $758.58 | $933.25 | $1,659.59 |
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 $371.54 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Where Illinois sits
The same service costs 4.3 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 $9,769TX $2,271
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.