How much rates vary
Facilitymedian $1,905 · 10th to 90th $759 to $5,248Professionalmedian $380 · 10th to 90th $282 to $575
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 $1,230.27 Typical High $5,623.41 | Facility | None | $436.52 | $1,230.27 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $467.74 | Professional | None | $275.42 | $302.00 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | None | $269.15 | $269.15 | $295.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $3,981.07 | Facility | None | $1,445.44 | $2,089.30 | $3,981.07 |
BCBS Illinois Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $575.44 | Professional | None | $380.19 | $478.63 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,659.59 Typical High $2,137.96 | Facility | None | $478.63 | $1,659.59 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $562.34 | Professional | None | $338.84 | $380.19 | $562.34 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,288.25 | Professional | None | $346.74 | $524.81 | $1,288.25 |
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 $398.11 Median $407.38 Typical High $446.68 | Professional | None | $398.11 | $407.38 | $446.68 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $416.87 | Professional | None | $33.11 | $33.11 | $416.87 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $645.65 | Professional | None | $288.40 | $363.08 | $645.65 |
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 $138.04 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $194.98 | $223.87 | $223.87 |
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 $4,812MT $1,050
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.