How much rates vary
Facilitymedian $1,820 · 10th to 90th $537 to $4,677Professionalmedian $398 · 10th to 90th $200 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 $213.80 Median $758.58 Typical High $4,677.35 | Facility | None | $213.80 | $758.58 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $363.08 Typical High $630.96 | Professional | None | $181.97 | $363.08 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $426.58 | Professional | None | $151.36 | $169.82 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $3,388.44 | Facility | None | $1,412.54 | $2,089.30 | $3,388.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $457.09 Typical High $812.83 | Professional | None | $213.80 | $457.09 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,659.59 Typical High $2,137.96 | Facility | None | $575.44 | $1,659.59 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $707.95 | Professional | None | $234.42 | $416.87 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $257.04 Median $575.44 Typical High $1,445.44 | Professional | None | $257.04 | $575.44 | $1,445.44 |
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 $229.09 Median $239.88 Typical High $562.34 | Professional | None | $229.09 | $239.88 | $562.34 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $630.96 | Professional | None | $33.11 | $33.11 | $630.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $2,398.83 Typical High $5,888.44 | Facility | None | $1,023.29 | $2,398.83 | $5,888.44 |
United Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $724.44 | Professional | None | $234.42 | $398.11 | $724.44 |
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 $89.13 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $89.13 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $69.18 Typical High $83.18 | Professional | 53 · Discontinued | $36.31 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $134.90 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $26.92 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $34.67 Typical High $41.69 | Professional | 56 · Pre-op care only | $18.20 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $125.89 | $239.88 | $295.12 |
Where Illinois sits
The same service costs 4.6 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 $4,728MT $1,029
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.