How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $11,482Professionalmedian $617 · 10th to 90th $501 to $1,047
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 $588.84 Median $2,238.72 Typical High $7,762.47 | Facility | None | $588.84 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $7,585.78 Typical High $12,302.69 | Facility | None | $5,495.41 | $7,585.78 | $12,302.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,071.52 | Professional | None | $660.69 | $891.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,606.93 Typical High $8,317.64 | Facility | None | $741.31 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $977.24 | Professional | None | $562.34 | $616.60 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $3,630.78 | Professional | None | $588.84 | $912.01 | $3,630.78 |
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 $645.65 Median $691.83 Typical High $776.25 | Professional | None | $645.65 | $691.83 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $61.66 Typical High $676.08 | Professional | None | $33.11 | $61.66 | $676.08 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,128.61 | $15,488.17 |
United Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,096.48 | Professional | None | $501.19 | $616.60 | $1,096.48 |
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 $251.19 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $389.05 |
Where Illinois sits
The same service costs 7.9 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 $13,941MT $1,762
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.