How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,349 to $10,233Professionalmedian $1,122 · 10th to 90th $813 to $1,622
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 $794.33 Median $1,905.46 Typical High $7,762.47 | Facility | None | $794.33 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | None | $794.33 | $891.25 | $891.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $11,481.54 | Facility | None | $2,511.89 | $3,981.07 | $11,481.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,380.38 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,884.03 Typical High $3,715.35 | Facility | None | $776.25 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,513.56 | Professional | None | $933.25 | $1,174.90 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $3,235.94 | Professional | None | $912.01 | $1,348.96 | $3,235.94 |
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 $954.99 Median $1,071.52 Typical High $1,202.26 | Professional | None | $954.99 | $1,071.52 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $95.50 Typical High $977.24 | Professional | None | $33.11 | $95.50 | $977.24 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $12,882.50 | Facility | None | $1,479.11 | $5,011.87 | $12,882.50 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $812.83 | $1,023.29 | $1,778.28 |
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 $398.11 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $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 $120.23 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $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 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.