How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,072 to $8,511Professionalmedian $1,514 · 10th to 90th $1,148 to $2,399
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 $831.76 Median $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,174.90 | $1,445.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,467.37 Median $5,623.41 Typical High $15,135.61 | Facility | None | $3,467.37 | $5,623.41 | $15,135.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,862.09 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,073.80 Typical High $5,128.61 | Facility | None | $776.25 | $4,073.80 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,348.96 | $2,187.76 |
Hally Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,168.69 | Professional | None | $1,202.26 | $1,862.09 | $4,168.69 |
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 $1,380.38 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,479.11 | $1,659.59 |
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 $7,762.47 | Facility | None | $1,047.13 | $2,454.71 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,513.56 | $2,570.40 |
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 $512.86 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $154.88 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $831.76 |
Where Illinois sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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 $10,675KY $2,405
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.