How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,072 to $10,715Professionalmedian $603 · 10th to 90th $389 to $851
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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $426.58 | Professional | None | $346.74 | $416.87 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $9,120.11 Typical High $11,220.18 | Facility | None | $5,495.41 | $9,120.11 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $812.83 | Professional | None | $489.78 | $676.08 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $8,511.38 Typical High $10,964.78 | Facility | None | $630.96 | $8,511.38 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $891.25 | Professional | None | $501.19 | $676.08 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,819.70 | Professional | None | $446.68 | $707.95 | $1,819.70 |
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 $501.19 Median $524.81 Typical High $575.44 | Professional | None | $501.19 | $524.81 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $467.74 | Professional | None | $33.11 | $45.71 | $467.74 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $10,471.29 | Facility | None | $1,174.90 | $3,090.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $831.76 | Professional | None | $371.54 | $467.74 | $831.76 |
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 $194.98 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $295.12 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $295.12 |
Where Illinois sits
The same service costs 8.3 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 $11,304MT $1,368
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.