How much rates vary
Facilitymedian $3,090 · 10th to 90th $741 to $6,607Professionalmedian $437 · 10th to 90th $324 to $661
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 $436.52 Median $1,258.93 Typical High $5,623.41 | Facility | None | $436.52 | $1,258.93 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $549.54 | Professional | None | $323.59 | $371.54 | $549.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $6,165.95 | Facility | None | $2,570.40 | $3,801.89 | $6,165.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $588.84 | Professional | None | $407.38 | $575.44 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $3,890.45 | Facility | None | $741.31 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $630.96 | Professional | None | $346.74 | $380.19 | $630.96 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $1,174.90 | Professional | None | $338.84 | $524.81 | $1,174.90 |
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 $389.05 Median $416.87 Typical High $457.09 | Professional | None | $389.05 | $416.87 | $457.09 |
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 $8,511.38 | Facility | None | $1,174.90 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $724.44 | Professional | None | $338.84 | $436.52 | $724.44 |
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 $162.18 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $245.47 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $263.03 |
Where Illinois sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.