How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,349 to $20,893Professionalmedian $1,698 · 10th to 90th $1,072 to $2,455
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 $1,000.00 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,000.00 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,096.48 | $1,096.48 |
BCBS Illinois Setting Facility Modifier None Typical Low $13,182.57 Median $16,982.44 Typical High $22,387.21 | Facility | None | $13,182.57 | $16,982.44 | $22,387.21 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,398.83 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $16,982.44 Typical High $21,379.62 | Facility | None | $776.25 | $16,982.44 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,348.96 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $4,168.69 | Professional | None | $1,148.15 | $1,737.80 | $4,168.69 |
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 $1,258.93 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,380.38 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $1,737.80 | Professional | None | $33.11 | $165.96 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $16,982.44 | Facility | None | $1,479.11 | $5,011.87 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,230.27 | $2,187.76 |
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 $501.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $776.25 | $776.25 |
Where Illinois sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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
AK $15,585KY $2,601
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.