How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,202 to $10,233Professionalmedian $977 · 10th to 90th $776 to $1,585
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 $758.58 Median $2,137.96 Typical High $7,762.47 | Facility | None | $758.58 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,174.90 | Professional | None | $724.44 | $912.01 | $1,174.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $11,220.18 | Facility | None | $4,570.88 | $6,760.83 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,380.38 | Professional | None | $891.25 | $1,258.93 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,248.07 Typical High $6,760.83 | Facility | None | $741.31 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,380.38 | Professional | None | $812.83 | $891.25 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,691.53 | Professional | None | $794.33 | $1,230.27 | $2,691.53 |
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 $933.25 Median $977.24 Typical High $1,096.48 | Professional | None | $933.25 | $977.24 | $1,096.48 |
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 $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,737.80 | Professional | None | $794.33 | $1,023.29 | $1,737.80 |
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 $363.08 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $645.65 | $645.65 |
Where Illinois sits
The same service costs 4.2 times more in Alaska 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
AK $10,315MT $2,461
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.