How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,096 to $10,965Professionalmedian $933 · 10th to 90th $676 to $1,413
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 $758.58 Median $1,995.26 Typical High $7,762.47 | Facility | None | $758.58 | $1,995.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,148.15 | Professional | None | $630.96 | $741.31 | $1,148.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $12,589.25 | Facility | None | $5,495.41 | $8,317.64 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,445.44 | Professional | None | $870.96 | $1,202.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,309.57 Typical High $8,317.64 | Facility | None | $891.25 | $6,309.57 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,318.26 | Professional | None | $812.83 | $977.24 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $3,090.30 | Professional | None | $794.33 | $1,202.26 | $3,090.30 |
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 $891.25 Median $954.99 Typical High $1,047.13 | Professional | None | $891.25 | $954.99 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $81.28 Typical High $912.01 | Professional | None | $33.11 | $81.28 | $912.01 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,479.11 | Professional | None | $676.08 | $851.14 | $1,479.11 |
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 $346.74 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $524.81 |
Where Illinois sits
The same service costs 5.7 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 $13,613MT $2,377
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.