How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,202 to $10,000Professionalmedian $776 · 10th to 90th $631 to $1,175
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 $676.08 Median $2,137.96 Typical High $7,762.47 | Facility | None | $676.08 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $1,047.13 | Professional | None | $630.96 | $676.08 | $1,047.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,466.84 Median $6,606.93 Typical High $10,471.29 | Facility | None | $4,466.84 | $6,606.93 | $10,471.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $891.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,174.90 | Professional | None | $630.96 | $870.96 | $1,174.90 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $2,691.53 | Professional | None | $676.08 | $977.24 | $2,691.53 |
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 $741.31 Median $831.76 Typical High $933.25 | Professional | None | $741.31 | $831.76 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $89.13 | Professional | None | $33.11 | $33.11 | $89.13 |
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 $645.65 Median $758.58 Typical High $1,258.93 | Professional | None | $645.65 | $758.58 | $1,258.93 |
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 $309.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Where Illinois sits
The same service costs 5.4 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 $11,084MT $2,070
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.