How much rates vary
Facilitymedian $4,365 · 10th to 90th $912 to $10,471Professionalmedian $676 · 10th to 90th $427 to $933
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 $602.56 Median $1,698.24 Typical High $5,623.41 | Facility | None | $602.56 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $724.44 | Professional | None | $416.87 | $467.74 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $436.52 | Professional | None | $309.03 | $398.11 | $436.52 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,370.32 Median $7,244.36 Typical High $10,964.78 | Facility | None | $5,370.32 | $7,244.36 | $10,964.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $912.01 | Professional | None | $549.54 | $758.58 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $6,456.54 Typical High $8,317.64 | Facility | None | $630.96 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $954.99 | Professional | None | $562.34 | $776.25 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $2,238.72 | Professional | None | $501.19 | $812.83 | $2,238.72 |
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 $575.44 Median $602.56 Typical High $660.69 | Professional | None | $575.44 | $602.56 | $660.69 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $51.29 Typical High $524.81 | Professional | None | $33.11 | $51.29 | $524.81 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $954.99 | Professional | None | $426.58 | $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 $218.78 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $302.00 | $331.13 | $331.13 |
Where Illinois sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.