How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,122 to $12,882Professionalmedian $457 · 10th to 90th $174 to $3,236
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 $436.52 Median $1,737.80 Typical High $5,888.44 | Facility | None | $436.52 | $1,737.80 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $2,041.74 | Professional | None | $269.15 | $457.09 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $1,905.46 | Professional | None | $257.04 | $257.04 | $1,905.46 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,365.16 Median $9,120.11 Typical High $12,302.69 | Facility | None | $4,365.16 | $9,120.11 | $12,302.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $363.08 Median $954.99 Typical High $3,235.94 | Professional | None | $363.08 | $954.99 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $10,232.93 Typical High $12,882.50 | Facility | None | $776.25 | $10,232.93 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $436.52 Typical High $3,235.94 | Professional | None | $125.89 | $436.52 | $3,235.94 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $2,238.72 Typical High $3,630.78 | Professional | None | $245.47 | $2,238.72 | $3,630.78 |
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 $389.05 Median $407.38 Typical High $2,691.53 | Professional | None | $389.05 | $407.38 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $2,818.38 | Professional | None | $33.11 | $33.11 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,135.61 | Facility | None | $1,479.11 | $5,011.87 | $15,135.61 |
United Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $2,884.03 | Professional | None | $162.18 | $309.03 | $2,884.03 |
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 $141.25 Median $234.42 Typical High $1,023.29 | Professional | 52 · Reduced service | $141.25 | $234.42 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $93.33 Typical High $407.38 | Professional | 53 · Discontinued | $56.23 | $93.33 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $354.81 Typical High $1,548.82 | Professional | 54 · Surgery only | $208.93 | $354.81 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $70.79 Typical High $309.03 | Professional | 55 · Aftercare only | $41.69 | $70.79 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $46.77 Typical High $204.17 | Professional | 56 · Pre-op care only | $28.18 | $46.77 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $331.13 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $194.98 | $331.13 | $1,445.44 |
Where Illinois sits
The same service costs 13.1 times more in Colorado 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
CO $15,603MT $1,192
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.