How much rates vary
Facilitymedian $2,692 · 10th to 90th $724 to $5,754Professionalmedian $575 · 10th to 90th $355 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 $489.78 Median $954.99 Typical High $5,623.41 | Facility | None | $489.78 | $954.99 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $562.34 | Professional | None | $309.03 | $416.87 | $562.34 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,630.78 Typical High $5,754.40 | Facility | None | $2,454.71 | $3,630.78 | $5,754.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $912.01 | Professional | None | $426.58 | $676.08 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,715.35 | Facility | None | $741.31 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $851.14 | Professional | None | $446.68 | $588.84 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,621.81 | Professional | None | $467.74 | $741.31 | $1,621.81 |
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 $436.52 Median $457.09 Typical High $724.44 | Professional | None | $436.52 | $457.09 | $724.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $63.10 Typical High $691.83 | Professional | None | $33.11 | $63.10 | $691.83 |
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 $371.54 Median $537.03 Typical High $954.99 | Professional | None | $371.54 | $537.03 | $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 $173.78 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $173.78 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $69.18 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $263.03 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $245.47 | $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 $6,438MT $1,383
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.