How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,175 to $15,488Professionalmedian $1,230 · 10th to 90th $933 to $1,905
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 $3,090.30 Typical High $9,332.54 | Facility | None | $933.25 | $3,090.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,621.81 | Professional | None | $933.25 | $933.25 | $1,621.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,659.59 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $9,120.11 Typical High $11,481.54 | Facility | None | $1,023.29 | $9,120.11 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,698.24 | Professional | None | $933.25 | $1,047.13 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,548.13 | Professional | None | $933.25 | $1,445.44 | $3,548.13 |
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 $1,071.52 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,148.15 | $1,258.93 |
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 $954.99 Median $1,258.93 Typical High $2,041.74 | Professional | None | $954.99 | $1,258.93 | $2,041.74 |
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 $467.74 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $741.31 |
Where Illinois sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.