How much rates vary
Facilitymedian $16,982 · 10th to 90th $1,072 to $34,674Professionalmedian $513 · 10th to 90th $355 to $724
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 $398.11 Median $1,621.81 Typical High $5,888.44 | Facility | None | $398.11 | $1,621.81 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $602.56 | Professional | None | $338.84 | $398.11 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | None | $177.83 | $177.83 | $181.97 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $25,703.96 Typical High $33,113.11 | Facility | None | $5,495.41 | $25,703.96 | $33,113.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $724.44 | Professional | None | $489.78 | $616.60 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $26,302.68 Typical High $34,673.69 | Facility | None | $645.65 | $26,302.68 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $707.95 | Professional | None | $426.58 | $512.86 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $2,884.03 | Professional | None | $416.87 | $645.65 | $2,884.03 |
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 $446.68 Median $501.19 Typical High $549.54 | Professional | None | $446.68 | $501.19 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $537.03 | Professional | None | $33.11 | $33.11 | $537.03 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $14,454.40 Typical High $42,657.95 | Facility | None | $2,238.72 | $14,454.40 | $42,657.95 |
United Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $831.76 | Professional | None | $354.81 | $467.74 | $831.76 |
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 $165.96 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $251.19 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $234.42 | $275.42 | $275.42 |
Where Illinois sits
The same service costs 29.4 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 $37,066MT $1,262
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.