How much rates vary
Facilitymedian $3,236 · 10th to 90th $741 to $6,026Professionalmedian $724 · 10th to 90th $209 to $1,514
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 $234.42 Median $1,230.27 Typical High $5,128.61 | Facility | None | $234.42 | $1,230.27 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $724.44 Typical High $1,122.02 | Professional | None | $199.53 | $724.44 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,754.23 Median $3,981.07 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,981.07 | $5,248.07 |
BCBS Illinois Setting Professional Modifier None Typical Low $208.93 Median $794.33 Typical High $1,548.82 | Professional | None | $208.93 | $794.33 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,715.35 Typical High $4,677.35 | Facility | None | $645.65 | $3,715.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $457.09 Typical High $1,258.93 | Professional | None | $213.80 | $457.09 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $954.99 Typical High $1,995.26 | Professional | None | $229.09 | $954.99 | $1,995.26 |
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 $213.80 Median $229.09 Typical High $954.99 | Professional | None | $213.80 | $229.09 | $954.99 |
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 $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $213.80 Median $691.83 Typical High $1,548.82 | Professional | None | $213.80 | $691.83 | $1,548.82 |
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 $97.72 Median $275.42 Typical High $446.68 | Professional | 52 · Reduced service | $97.72 | $275.42 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $112.20 Typical High $177.83 | Professional | 53 · Discontinued | $39.81 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $416.87 Typical High $676.08 | Professional | 54 · Surgery only | $147.91 | $416.87 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $83.18 Typical High $134.90 | Professional | 55 · Aftercare only | $29.51 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $54.95 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.95 | $54.95 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $389.05 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $138.04 | $389.05 | $630.96 |
Where Illinois sits
The same service costs 5.1 times more in Colorado 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
CO $7,315MT $1,443
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.