How much rates vary
Facilitymedian $2,818 · 10th to 90th $851 to $5,754Professionalmedian $389 · 10th to 90th $251 to $741
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 $331.13 Median $1,380.38 Typical High $5,623.41 | Facility | None | $331.13 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | None | $245.47 | $269.15 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,467.37 Typical High $5,623.41 | Facility | None | $2,454.71 | $3,467.37 | $5,623.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $524.81 | Professional | None | $316.23 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,884.03 Typical High $3,715.35 | Facility | None | $478.63 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $758.58 | Professional | None | $323.59 | $426.58 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $1,318.26 | Professional | None | $295.12 | $467.74 | $1,318.26 |
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 $323.59 Median $346.74 Typical High $380.19 | Professional | None | $323.59 | $346.74 | $380.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $354.81 | Professional | None | $33.11 | $33.11 | $354.81 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $575.44 | Professional | None | $251.19 | $331.13 | $575.44 |
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 $125.89 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $177.83 | $190.55 | $190.55 |
Where Illinois sits
The same service costs 7.3 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 $6,269MT $863
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.