How much rates vary
Facilitymedian $316 · 10th to 90th $141 to $2,089Professionalmedian $158 · 10th to 90th $93 to $245
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 $151.36 Median $812.83 Typical High $5,128.61 | Facility | None | $151.36 | $812.83 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $151.36 | Professional | None | $69.18 | $104.71 | $151.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $1,230.27 | Facility | None | $151.36 | $245.47 | $1,230.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $245.47 | Professional | None | $125.89 | $181.97 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $269.15 | Facility | None | $102.33 | $190.55 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $223.87 | Professional | None | $128.82 | $162.18 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $398.11 | Professional | None | $120.23 | $181.97 | $398.11 |
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 $112.20 Median $120.23 Typical High $177.83 | Professional | None | $112.20 | $120.23 | $177.83 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $33.11 Typical High $199.53 | Professional | None | $23.44 | $33.11 | $199.53 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $213.80 | Professional | None | $87.10 | $114.82 | $213.80 |
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 $45.71 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $18.20 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $79.43 Typical High $93.33 | Professional | 54 · Surgery only | $67.61 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $74.13 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $63.10 | $74.13 | $87.10 |
Where Illinois sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.