How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $12,589Professionalmedian $1,259 · 10th to 90th $977 to $2,042
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 $977.24 Median $1,778.28 Typical High $9,120.11 | Facility | None | $977.24 | $1,778.28 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,621.81 | Professional | None | $912.01 | $1,071.52 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $1,047.13 Typical High $1,513.56 | Professional | None | $128.82 | $1,047.13 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $13,803.84 | Facility | None | $5,623.41 | $8,317.64 | $13,803.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,698.24 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $6,606.93 Typical High $8,317.64 | Facility | None | $1,071.52 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,230.27 | $1,862.09 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,148.15 | $1,737.80 | $4,466.84 |
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 $1,258.93 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,348.96 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $117.49 Typical High $1,288.25 | Professional | None | $33.11 | $117.49 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,089.30 | Professional | None | $977.24 | $1,230.27 | $2,089.30 |
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 $501.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $758.58 |
Where Illinois sits
The same service costs 4.2 times more in Colorado 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
CO $14,362MT $3,396
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.