How much rates vary
Facilitymedian $3,090 · 10th to 90th $708 to $6,607Professionalmedian $447 · 10th to 90th $331 to $676
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 $446.68 Median $1,230.27 Typical High $5,623.41 | Facility | None | $446.68 | $1,230.27 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $575.44 | Professional | None | $331.13 | $380.19 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $6,309.57 | Facility | None | $2,630.27 | $3,890.45 | $6,309.57 |
BCBS Illinois Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $602.56 | Professional | None | $416.87 | $588.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $3,890.45 | Facility | None | $741.31 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $645.65 | Professional | None | $346.74 | $398.11 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $1,230.27 | Professional | None | $346.74 | $537.03 | $1,230.27 |
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 $407.38 Median $426.58 Typical High $467.74 | Professional | None | $407.38 | $426.58 | $467.74 |
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 $346.74 Median $446.68 Typical High $741.31 | Professional | None | $346.74 | $446.68 | $741.31 |
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 $165.96 Median $190.55 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $251.19 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $275.42 |
Where Illinois sits
The same service costs 7.8 times more in Vermont 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
VT $8,433MT $1,087
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.