How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,445 to $12,882Professionalmedian $1,950 · 10th to 90th $1,288 to $3,388
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 $1,148.15 Median $4,168.69 Typical High $14,125.38 | Facility | None | $1,148.15 | $4,168.69 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,905.46 | $1,905.46 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,244.36 Typical High $20,892.96 | Facility | None | $4,570.88 | $7,244.36 | $20,892.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,398.83 | $3,019.95 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,380.38 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,949.84 | $3,019.95 |
Hally Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $7,943.28 | Professional | None | $1,778.28 | $2,691.53 | $7,943.28 |
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 $2,187.76 Median $2,290.87 Typical High $2,511.89 | Professional | None | $2,187.76 | $2,290.87 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $229.09 | Professional | None | $33.11 | $33.11 | $229.09 |
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 $1,778.28 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,137.96 | $3,548.13 |
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 $912.01 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $912.01 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,348.96 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,318.26 | $1,318.26 |
Where Illinois sits
The same service costs 3.0 times more in Alaska than in Delaware. 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 $13,579DE $4,544
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.