How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,288 to $10,965Professionalmedian $1,698 · 10th to 90th $1,230 to $2,754
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 $1,122.02 Median $3,235.94 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,445.44 | $1,698.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $13,489.63 | Facility | None | $4,570.88 | $6,760.83 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,995.26 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,023.29 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,621.81 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $4,570.88 | Professional | None | $1,288.25 | $2,089.30 | $4,570.88 |
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 $1,445.44 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,513.56 | $1,995.26 |
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 $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,862.09 | $3,162.28 |
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 $602.56 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,047.13 |
Where Illinois sits
The same service costs 3.2 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 $12,311KY $3,892
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.