How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,023 to $5,754Professionalmedian $398 · 10th to 90th $295 to $617
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 $660.69 Median $3,235.94 Typical High $7,762.47 | Facility | None | $660.69 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $501.19 | Professional | None | $295.12 | $295.12 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $4,570.88 | Facility | None | $1,513.56 | $2,238.72 | $4,570.88 |
BCBS Illinois Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $575.44 | Professional | None | $354.81 | $537.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $2,398.83 | Facility | None | $891.25 | $1,819.70 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $549.54 | Professional | None | $316.23 | $346.74 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $1,445.44 | Professional | None | $302.00 | $467.74 | $1,445.44 |
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 $346.74 Median $363.08 Typical High $398.11 | Professional | None | $346.74 | $363.08 | $398.11 |
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 $1,047.13 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $630.96 | Professional | None | $295.12 | $407.38 | $630.96 |
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 $147.91 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $234.42 |
Where Illinois sits
The same service costs 6.6 times more in Oklahoma 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
OK $6,126MT $925
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.