How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,349 to $20,417Professionalmedian $813 · 10th to 90th $589 to $1,175
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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $933.25 | Professional | None | $562.34 | $616.60 | $933.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,709.64 Median $16,595.87 Typical High $21,379.62 | Facility | None | $8,709.64 | $16,595.87 | $21,379.62 |
BCBS Illinois Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,174.90 | Professional | None | $724.44 | $977.24 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $16,595.87 Typical High $21,379.62 | Facility | None | $891.25 | $16,595.87 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,071.52 | Professional | None | $676.08 | $831.76 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $2,290.87 | Professional | None | $660.69 | $1,000.00 | $2,290.87 |
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 $741.31 Median $776.25 Typical High $851.14 | Professional | None | $741.31 | $776.25 | $851.14 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $67.61 Typical High $676.08 | Professional | None | $33.11 | $67.61 | $676.08 |
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 $549.54 Median $707.95 Typical High $1,230.27 | Professional | None | $549.54 | $707.95 | $1,230.27 |
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 $281.84 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $426.58 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $426.58 |
Where Illinois sits
The same service costs 10.1 times more in Alaska 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
AK $19,890MT $1,977
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.