How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,259 to $12,589Professionalmedian $977 · 10th to 90th $724 to $1,380
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 $2,137.96 Typical High $7,762.47 | Facility | None | $758.58 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,000.00 | Professional | None | $691.83 | $776.25 | $1,000.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,244.36 Median $9,332.54 Typical High $13,489.63 | Facility | None | $7,244.36 | $9,332.54 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,380.38 | Professional | None | $851.14 | $1,174.90 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,511.38 Typical High $10,964.78 | Facility | None | $741.31 | $8,511.38 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,288.25 | Professional | None | $794.33 | $1,000.00 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,511.89 | Professional | None | $794.33 | $1,202.26 | $2,511.89 |
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 $870.96 Median $933.25 Typical High $1,047.13 | Professional | None | $870.96 | $933.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $79.43 Typical High $812.83 | Professional | None | $33.11 | $79.43 | $812.83 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,548.82 | Professional | None | $707.95 | $851.14 | $1,548.82 |
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 $354.81 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $537.03 |
Where Illinois sits
The same service costs 6.0 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 $14,230MT $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.