How much rates vary
Facilitymedian $2,399 · 10th to 90th $933 to $5,754Professionalmedian $661 · 10th to 90th $417 to $1,000
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 $537.03 Median $1,737.80 Typical High $5,623.41 | Facility | None | $537.03 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $588.84 | Professional | None | $389.05 | $501.19 | $588.84 |
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 $489.78 Median $724.44 Typical High $1,000.00 | Professional | None | $489.78 | $724.44 | $1,000.00 |
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 $489.78 Median $645.65 Typical High $933.25 | Professional | None | $489.78 | $645.65 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,288.25 | Professional | None | $524.81 | $794.33 | $1,288.25 |
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 $489.78 Median $524.81 Typical High $794.33 | Professional | None | $489.78 | $524.81 | $794.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $69.18 Typical High $691.83 | Professional | None | $33.11 | $69.18 | $691.83 |
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 $407.38 Median $575.44 Typical High $1,000.00 | Professional | None | $407.38 | $575.44 | $1,000.00 |
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 $204.17 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $302.00 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $281.84 | $346.74 | $407.38 |
Where Illinois sits
The same service costs 4.4 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 $6,491MT $1,489
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.