How much rates vary
Facilitymedian $2,344 · 10th to 90th $550 to $5,129Professionalmedian $355 · 10th to 90th $186 to $891
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 $257.04 Median $1,000.00 Typical High $5,128.61 | Facility | None | $257.04 | $1,000.00 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $467.74 Typical High $588.84 | Professional | None | $186.21 | $467.74 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $257.04 | Professional | None | $158.49 | $251.19 | $257.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $4,073.80 | Facility | None | $1,862.09 | $2,818.38 | $4,073.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $208.93 Median $537.03 Typical High $831.76 | Professional | None | $208.93 | $537.03 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,511.89 Typical High $3,235.94 | Facility | None | $478.63 | $2,511.89 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $954.99 | Professional | None | $204.17 | $354.81 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $676.08 Typical High $1,479.11 | Professional | None | $223.87 | $676.08 | $1,479.11 |
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 $218.78 Median $229.09 Typical High $724.44 | Professional | None | $218.78 | $229.09 | $724.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $81.28 | Professional | None | $33.11 | $33.11 | $81.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $6,606.93 | Facility | None | $1,047.13 | $2,454.71 | $6,606.93 |
United Setting Professional Modifier None Typical Low $190.55 Median $446.68 Typical High $954.99 | Professional | None | $190.55 | $446.68 | $954.99 |
7 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 $93.33 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $93.33 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $37.15 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $138.04 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $27.54 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $18.62 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $128.82 | $323.59 | $380.19 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 59 · Distinct service | $173.78 | $173.78 | $173.78 |
Where Illinois sits
The same service costs 4.4 times more in Colorado than in North Dakota. 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 $4,844ND $1,099
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.