How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,148 to $12,882Professionalmedian $1,202 · 10th to 90th $933 to $1,778
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 $812.83 Median $1,905.46 Typical High $5,888.44 | Facility | None | $812.83 | $1,905.46 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,445.44 | Professional | None | $870.96 | $1,023.29 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,309.57 Median $9,332.54 Typical High $15,488.17 | Facility | None | $6,309.57 | $9,332.54 | $15,488.17 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,244.36 Typical High $9,332.54 | Facility | None | $630.96 | $7,244.36 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,202.26 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $5,623.41 | Professional | None | $1,071.52 | $1,621.81 | $5,623.41 |
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 $1,148.15 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,258.93 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,230.27 | Professional | None | $33.11 | $33.11 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,089.30 | Professional | None | $933.25 | $1,174.90 | $2,089.30 |
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 $436.52 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $645.65 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $602.56 | $707.95 | $707.95 |
Where Illinois sits
The same service costs 4.4 times more in Alaska 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
AK $10,992HI $2,489
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.