How much rates vary
Facilitymedian $25,119 · 10th to 90th $1,349 to $50,119Professionalmedian $1,259 · 10th to 90th $933 to $1,995
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 $1,023.29 Median $2,238.72 Typical High $15,488.17 | Facility | None | $1,023.29 | $2,238.72 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,862.09 | Professional | None | $851.14 | $1,122.02 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,096.48 | $1,548.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $11,481.54 Median $35,481.34 Typical High $46,773.51 | Facility | None | $11,481.54 | $35,481.34 | $46,773.51 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,258.93 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $43,651.58 Typical High $50,118.72 | Facility | None | $776.25 | $43,651.58 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,698.24 | Professional | None | $977.24 | $1,202.26 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $3,548.13 | Professional | None | $912.01 | $1,412.54 | $3,548.13 |
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 $1,023.29 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,148.15 | $1,288.25 |
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 $2,884.03 Median $23,442.29 Typical High $67,608.30 | Facility | None | $2,884.03 | $23,442.29 | $67,608.30 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,137.96 | Professional | None | $977.24 | $1,348.96 | $2,137.96 |
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 $501.19 Median $562.34 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $794.33 |
Where Illinois sits
The same service costs 19.9 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 $53,750MT $2,699
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.