How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,023 to $9,550Professionalmedian $1,000 · 10th to 90th $724 to $1,413
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 $741.31 Median $1,621.81 Typical High $8,709.64 | Facility | None | $741.31 | $1,621.81 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,230.27 | Professional | None | $645.65 | $741.31 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $870.96 | Professional | None | $426.58 | $794.33 | $870.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,466.84 Median $6,456.54 Typical High $9,549.93 | Facility | None | $4,466.84 | $6,456.54 | $9,549.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,318.26 | Professional | None | $891.25 | $1,174.90 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,248.07 Typical High $6,760.83 | Facility | None | $1,023.29 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,380.38 | Professional | None | $794.33 | $870.96 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,454.71 | Professional | None | $758.58 | $1,174.90 | $2,454.71 |
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 $870.96 Median $933.25 Typical High $1,047.13 | Professional | None | $870.96 | $933.25 | $1,047.13 |
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 $1,288.25 Median $4,168.69 Typical High $11,748.98 | Facility | None | $1,288.25 | $4,168.69 | $11,748.98 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,621.81 | Professional | None | $758.58 | $977.24 | $1,621.81 |
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 $323.59 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $512.86 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $512.86 | $524.81 |
Where Illinois sits
The same service costs 4.5 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 $10,099MT $2,245
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.