How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,175 to $12,303Professionalmedian $1,072 · 10th to 90th $794 to $1,660
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 $870.96 Median $1,479.11 Typical High $5,623.41 | Facility | None | $870.96 | $1,479.11 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,348.96 | Professional | None | $707.95 | $870.96 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,096.48 | $1,096.48 | $1,174.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,244.36 Median $9,549.93 Typical High $13,489.63 | Facility | None | $7,244.36 | $9,549.93 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,412.54 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,511.38 Typical High $10,715.19 | Facility | None | $741.31 | $8,511.38 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,548.82 | Professional | None | $933.25 | $1,096.48 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $3,715.35 | Professional | None | $933.25 | $1,412.54 | $3,715.35 |
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 $1,023.29 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,096.48 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $97.72 Typical High $1,023.29 | Professional | None | $33.11 | $97.72 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,128.61 | $15,848.93 |
United Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,737.80 | Professional | None | $794.33 | $977.24 | $1,737.80 |
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 $407.38 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $616.60 |
Where Illinois sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.