How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,413 to $16,982Professionalmedian $1,175 · 10th to 90th $447 to $9,772
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 $933.25 Median $5,128.61 Typical High $12,882.50 | Facility | None | $933.25 | $5,128.61 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $5,128.61 Typical High $5,888.44 | Professional | None | $446.68 | $5,128.61 | $5,888.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,370.32 Median $13,489.63 Typical High $16,982.44 | Facility | None | $5,370.32 | $13,489.63 | $16,982.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $489.78 Median $2,089.30 Typical High $9,772.37 | Professional | None | $489.78 | $2,089.30 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $13,489.63 Typical High $17,378.01 | Facility | None | $776.25 | $13,489.63 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $1,023.29 Typical High $9,549.93 | Professional | None | $524.81 | $1,023.29 | $9,549.93 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $6,760.83 Typical High $9,772.37 | Professional | None | $562.34 | $6,760.83 | $9,772.37 |
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 $524.81 Median $562.34 Typical High $7,244.36 | Professional | None | $524.81 | $562.34 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $537.03 | Professional | None | $33.11 | $33.11 | $537.03 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $489.78 Median $5,128.61 Typical High $12,022.64 | Professional | None | $489.78 | $5,128.61 | $12,022.64 |
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 $223.87 Median $2,511.89 Typical High $2,951.21 | Professional | 52 · Reduced service | $223.87 | $2,511.89 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $1,023.29 Typical High $1,174.90 | Professional | 53 · Discontinued | $89.13 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $3,801.89 Typical High $4,466.84 | Professional | 54 · Surgery only | $338.84 | $3,801.89 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $758.58 Typical High $891.25 | Professional | 55 · Aftercare only | $67.61 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $512.86 Typical High $588.84 | Professional | 56 · Pre-op care only | $44.67 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $3,548.13 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $316.23 | $3,548.13 | $4,168.69 |
Where Illinois sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.