How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,023 to $5,888Professionalmedian $537 · 10th to 90th $398 to $871
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 $524.81 Median $1,862.09 Typical High $5,888.44 | Facility | None | $524.81 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $691.83 | Professional | None | $416.87 | $524.81 | $691.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $6,165.95 | Facility | None | $2,238.72 | $3,311.31 | $6,165.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $831.76 | Professional | None | $524.81 | $741.31 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,630.27 Typical High $3,311.31 | Facility | None | $630.96 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $812.83 | Professional | None | $398.11 | $501.19 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,288.25 | Professional | None | $436.52 | $691.83 | $1,288.25 |
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 $549.54 Median $562.34 Typical High $630.96 | Professional | None | $549.54 | $562.34 | $630.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $426.58 Median $549.54 Typical High $977.24 | Professional | None | $426.58 | $549.54 | $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 $208.93 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $288.40 | $371.54 | $371.54 |
Where Illinois sits
The same service costs 3.6 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 $5,175MT $1,450
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.