How much rates vary
Facilitymedian $1,778 · 10th to 90th $269 to $3,631Professionalmedian $229 · 10th to 90th $145 to $372
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 $173.78 Median $363.08 Typical High $4,677.35 | Facility | None | $173.78 | $363.08 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $269.15 | Professional | None | $128.82 | $190.55 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,235.94 | Facility | None | $1,659.59 | $2,238.72 | $3,235.94 |
BCBS Illinois Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $371.54 | Professional | None | $158.49 | $239.88 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,995.26 Typical High $2,511.89 | Facility | None | $478.63 | $1,995.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $331.13 | Professional | None | $144.54 | $223.87 | $331.13 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $549.54 | Professional | None | $162.18 | $269.15 | $549.54 |
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 $158.49 Median $165.96 Typical High $263.03 | Professional | None | $158.49 | $165.96 | $263.03 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $371.54 | Professional | None | $138.04 | $218.78 | $371.54 |
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 $66.07 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $66.07 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $19.95 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.18 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $131.83 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $131.83 | $151.36 |
Where Illinois sits
The same service costs 9.9 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 $4,605MT $466
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.