How much rates vary
Facilitymedian $2,399 · 10th to 90th $912 to $5,754Professionalmedian $631 · 10th to 90th $398 to $912
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 $478.63 Median $1,698.24 Typical High $5,623.41 | Facility | None | $478.63 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $602.56 | Professional | None | $316.23 | $407.38 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,905.46 | $2,754.23 | $5,495.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $891.25 | Professional | None | $467.74 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $2,818.38 | Facility | None | $630.96 | $2,187.76 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $912.01 | Professional | None | $501.19 | $691.83 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,778.28 | Professional | None | $489.78 | $758.58 | $1,778.28 |
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 $467.74 Median $489.78 Typical High $707.95 | Professional | None | $467.74 | $489.78 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $61.66 Typical High $630.96 | Professional | None | $33.11 | $61.66 | $630.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $6,918.31 | Facility | None | $1,047.13 | $2,454.71 | $6,918.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $954.99 | Professional | None | $389.05 | $549.54 | $954.99 |
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 $190.55 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $190.55 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $75.86 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $281.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $56.23 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $371.54 |
Where Illinois sits
The same service costs 4.7 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 $6,464MT $1,390
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.