How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,585 to $13,490Professionalmedian $1,660 · 10th to 90th $1,202 to $2,512
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 $1,122.02 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,122.02 | $2,344.23 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,348.96 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,023.29 | $1,659.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $17,378.01 | Facility | None | $5,623.41 | $8,317.64 | $17,378.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,659.59 | $2,089.30 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $6,760.83 Typical High $8,912.51 | Facility | None | $1,862.09 | $6,760.83 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,698.24 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $5,888.44 | Professional | None | $1,445.44 | $2,137.96 | $5,888.44 |
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 $1,479.11 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,698.24 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,737.80 | Professional | None | $33.11 | $33.11 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,495.41 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,495.41 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,548.82 | $2,691.53 |
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 $575.44 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $954.99 | $954.99 |
Where Illinois sits
The same service costs 4.7 times more in Colorado 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
CO $15,002KY $3,224
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.