How much rates vary
Facilitymedian $2,818 · 10th to 90th $776 to $5,623Professionalmedian $257 · 10th to 90th $182 to $355
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 $181.97 Median $1,584.89 Typical High $5,623.41 | Facility | None | $181.97 | $1,584.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $302.00 | Professional | None | $162.18 | $181.97 | $302.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $4,897.79 | Facility | None | $2,238.72 | $3,388.44 | $4,897.79 |
BCBS Illinois Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $323.59 | Professional | None | $218.78 | $288.40 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,090.30 Typical High $3,890.45 | Facility | None | $630.96 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $309.03 | Professional | None | $199.53 | $251.19 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $891.25 | Professional | None | $186.21 | $295.12 | $891.25 |
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 $213.80 Median $229.09 Typical High $257.04 | Professional | None | $213.80 | $229.09 | $257.04 |
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 $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $398.11 | Professional | None | $186.21 | $245.47 | $398.11 |
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 $77.62 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $31.62 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $141.25 | Professional | 54 · Surgery only | $117.49 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $28.18 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $125.89 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $109.65 | $125.89 | $131.83 |
Where Illinois sits
The same service costs 8.1 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 $4,634MT $570
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.