How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $9,120Professionalmedian $1,349 · 10th to 90th $1,023 to $2,344
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 $2,951.21 Typical High $7,762.47 | Facility | None | $977.24 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,584.89 | Professional | None | $977.24 | $1,230.27 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $14,125.38 | Facility | None | $4,570.88 | $6,760.83 | $14,125.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,659.59 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $891.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,412.54 | $1,905.46 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $4,168.69 | Professional | None | $1,096.48 | $1,698.24 | $4,168.69 |
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 $1,479.11 | Professional | None | $1,258.93 | $1,348.96 | $1,479.11 |
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 $7,943.28 | Facility | None | $1,047.13 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,412.54 | $2,454.71 |
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 $489.78 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $851.14 | $851.14 |
Where Illinois sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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 $11,283KY $2,440
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.