How much rates vary
Facilitymedian $4,365 · 10th to 90th $977 to $9,333Professionalmedian $955 · 10th to 90th $708 to $1,660
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 $758.58 Median $1,778.28 Typical High $5,623.41 | Facility | None | $758.58 | $1,778.28 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,122.02 | Professional | None | $794.33 | $794.33 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,168.69 Median $6,025.60 Typical High $12,302.69 | Facility | None | $4,168.69 | $6,025.60 | $12,302.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,659.59 | Professional | None | $812.83 | $1,202.26 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $4,786.30 Typical High $6,165.95 | Facility | None | $478.63 | $4,786.30 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,445.44 | Professional | None | $707.95 | $912.01 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $3,388.44 | Professional | None | $758.58 | $1,230.27 | $3,388.44 |
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 $933.25 Median $1,000.00 Typical High $1,071.52 | Professional | None | $933.25 | $1,000.00 | $1,071.52 |
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 $1,174.90 Median $3,090.30 Typical High $9,772.37 | Facility | None | $1,174.90 | $3,090.30 | $9,772.37 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,737.80 | Professional | None | $776.25 | $1,071.52 | $1,737.80 |
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 $398.11 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $630.96 |
Where Illinois sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.