How much rates vary
Facilitymedian $3,090 · 10th to 90th $871 to $7,079Professionalmedian $741 · 10th to 90th $525 to $1,122
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 $707.95 Median $1,621.81 Typical High $7,762.47 | Facility | None | $707.95 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $977.24 | Professional | None | $501.19 | $575.44 | $977.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $7,585.78 | Facility | None | $2,630.27 | $3,890.45 | $7,585.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,071.52 | Professional | None | $724.44 | $954.99 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $3,890.45 | Facility | None | $1,023.29 | $3,162.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | None | $524.81 | $676.08 | $1,023.29 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $2,041.74 | Professional | None | $588.84 | $912.01 | $2,041.74 |
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 $691.83 Median $741.31 Typical High $812.83 | Professional | None | $691.83 | $741.31 | $812.83 |
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 $537.03 Median $707.95 Typical High $1,202.26 | Professional | None | $537.03 | $707.95 | $1,202.26 |
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 $251.19 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $354.81 | $407.38 | $407.38 |
Where Illinois sits
The same service costs 3.6 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 $6,446MT $1,806
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.