How much rates vary
Facilitymedian $2,692 · 10th to 90th $741 to $5,754Professionalmedian $589 · 10th to 90th $389 to $933
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 $512.86 Median $977.24 Typical High $5,623.41 | Facility | None | $512.86 | $977.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $575.44 | Professional | None | $316.23 | $426.58 | $575.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,630.78 Typical High $6,025.60 | Facility | None | $2,454.71 | $3,630.78 | $6,025.60 |
BCBS Illinois Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $933.25 | Professional | None | $467.74 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,715.35 | Facility | None | $741.31 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $870.96 | Professional | None | $426.58 | $616.60 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,513.56 | Professional | None | $467.74 | $758.58 | $1,513.56 |
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 $489.78 Median $501.19 Typical High $741.31 | Professional | None | $489.78 | $501.19 | $741.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $63.10 Typical High $645.65 | Professional | None | $33.11 | $63.10 | $645.65 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $977.24 | Professional | None | $380.19 | $562.34 | $977.24 |
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 $199.53 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $199.53 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $112.20 | Professional | 53 · Discontinued | $79.43 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $295.12 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $39.81 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $275.42 | $331.13 | $389.05 |
Where Illinois sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.