How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,000 to $5,888Professionalmedian $603 · 10th to 90th $437 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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $794.33 | Professional | None | $380.19 | $478.63 | $794.33 |
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 $489.78 Median $691.83 Typical High $758.58 | Professional | None | $489.78 | $691.83 | $758.58 |
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 $446.68 Median $602.56 Typical High $776.25 | Professional | None | $446.68 | $602.56 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $1,698.24 | Professional | None | $426.58 | $660.69 | $1,698.24 |
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 $501.19 Median $524.81 Typical High $575.44 | Professional | None | $501.19 | $524.81 | $575.44 |
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 $436.52 Median $575.44 Typical High $977.24 | Professional | None | $436.52 | $575.44 | $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 $190.55 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $190.55 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $75.86 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $263.03 | $338.84 | $338.84 |
Where Illinois sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.