How much rates vary
Facilitymedian $2,138 · 10th to 90th $851 to $5,623Professionalmedian $417 · 10th to 90th $316 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 $426.58 Median $1,659.59 Typical High $7,079.46 | Facility | None | $426.58 | $1,659.59 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $537.03 | Professional | None | $316.23 | $363.08 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $4,677.35 | Facility | None | $1,513.56 | $2,238.72 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $575.44 | Professional | None | $389.05 | $562.34 | $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 $346.74 Median $371.54 Typical High $616.60 | Professional | None | $346.74 | $371.54 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $1,096.48 | Professional | None | $331.13 | $512.86 | $1,096.48 |
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 $407.38 Typical High $446.68 | Professional | None | $389.05 | $407.38 | $446.68 |
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 $331.13 Median $426.58 Typical High $707.95 | Professional | None | $331.13 | $426.58 | $707.95 |
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 $158.49 Median $181.97 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $74.13 | Professional | 53 · Discontinued | $64.57 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $281.84 | Professional | 54 · Surgery only | $239.88 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $36.31 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $263.03 |
Where Illinois sits
The same service costs 5.1 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 $5,094MT $991
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.