How much rates vary
Facilitymedian $2,138 · 10th to 90th $871 to $5,370Professionalmedian $324 · 10th to 90th $182 to $562
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 $371.54 Median $1,737.80 Typical High $5,623.41 | Facility | None | $371.54 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $426.58 | Professional | None | $181.97 | $302.00 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $3,890.45 | Facility | None | $1,621.81 | $2,290.87 | $3,890.45 |
BCBS Illinois Setting Professional Modifier None Typical Low $186.21 Median $354.81 Typical High $562.34 | Professional | None | $186.21 | $354.81 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,995.26 Typical High $2,454.71 | Facility | None | $630.96 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $524.81 | Professional | None | $173.78 | $331.13 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $398.11 Typical High $724.44 | Professional | None | $186.21 | $398.11 | $724.44 |
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 $218.78 Median $218.78 Typical High $426.58 | Professional | None | $218.78 | $218.78 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $6,165.95 | Facility | None | $1,047.13 | $2,454.71 | $6,165.95 |
United Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $616.60 | Professional | None | $186.21 | $331.13 | $616.60 |
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 $91.20 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $91.20 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $36.31 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $239.88 Typical High $275.42 | Professional | 54 · Surgery only | $134.90 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $47.86 Typical High $54.95 | Professional | 55 · Aftercare only | $27.54 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $223.87 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $125.89 | $223.87 | $257.04 |
Where Illinois sits
The same service costs 6.3 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 $4,654MT $736
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.