How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,122 to $9,120Professionalmedian $1,230 · 10th to 90th $955 to $1,950
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 $851.14 Median $1,862.09 Typical High $5,623.41 | Facility | None | $851.14 | $1,862.09 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | None | $912.01 | $1,071.52 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,311.31 Median $4,570.88 Typical High $13,489.63 | Facility | None | $3,311.31 | $4,570.88 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,584.89 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,890.45 Typical High $4,897.79 | Facility | None | $630.96 | $3,890.45 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,258.93 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,122.02 | $1,698.24 | $3,890.45 |
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 $1,230.27 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,348.96 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,348.96 | Professional | None | $33.11 | $33.11 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,073.80 | $10,471.29 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,187.76 | Professional | None | $977.24 | $1,202.26 | $2,187.76 |
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 $457.09 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $457.09 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $676.08 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $630.96 | $741.31 | $741.31 |
Where Illinois sits
The same service costs 5.3 times more in Vermont than in Hawaii. 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
VT $13,652HI $2,577
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.