How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,259 to $11,220Professionalmedian $1,479 · 10th to 90th $1,072 to $2,188
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 $977.24 Median $1,905.46 Typical High $9,120.11 | Facility | None | $977.24 | $1,905.46 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,122.02 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,918.31 Typical High $14,454.40 | Facility | None | $4,570.88 | $6,918.31 | $14,454.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,778.28 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,495.41 Typical High $7,244.36 | Facility | None | $776.25 | $5,495.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,380.38 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $4,168.69 | Professional | None | $1,096.48 | $1,698.24 | $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 $1,258.93 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,380.38 | $1,548.82 |
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 $12,882.50 | Facility | None | $1,288.25 | $4,168.69 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,412.54 | $2,398.83 |
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 $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $776.25 |
Where Illinois sits
The same service costs 3.7 times more in Alaska than in West Virginia. 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 $11,610WV $3,177
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.