How much rates vary
Facilitymedian $1,950 · 10th to 90th $525 to $19,953Professionalmedian $6,457 · 10th to 90th $4,467 to $10,471
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 $933.25 Median $4,677.35 Typical High $9,772.37 | Facility | None | $933.25 | $4,677.35 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $5,754.40 Typical High $5,754.40 | Professional | None | $4,466.84 | $5,754.40 | $5,754.40 |
BCBS Illinois Setting Facility Modifier None Typical Low $30,902.95 Median $66,069.34 Typical High $134,896.29 | Facility | None | $30,902.95 | $66,069.34 | $134,896.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $9,549.93 | Professional | None | $6,165.95 | $8,912.51 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
Hally Health Setting Professional Modifier None Typical Low $4,265.80 Median $7,585.78 Typical High $28,840.32 | Professional | None | $4,265.80 | $7,585.78 | $28,840.32 |
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 $5,370.32 Median $6,309.57 Typical High $7,079.46 | Professional | None | $5,370.32 | $6,309.57 | $7,079.46 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $4,168.69 Median $6,025.60 Typical High $11,481.54 | Professional | None | $4,168.69 | $6,025.60 | $11,481.54 |
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 $2,238.72 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,238.72 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $891.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,311.31 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $660.69 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $446.68 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,981.07 | $3,981.07 |
Where Illinois sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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
WI $28,671TX $3,407
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.