How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,175 to $8,511Professionalmedian $955 · 10th to 90th $741 to $1,413
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 $891.25 Median $3,235.94 Typical High $7,762.47 | Facility | None | $891.25 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,288.25 | Professional | None | $812.83 | $891.25 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,073.80 Typical High $10,232.93 | Facility | None | $2,630.27 | $4,073.80 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,288.25 | Professional | None | $831.76 | $1,202.26 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $3,890.45 | Facility | None | $891.25 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,230.27 | Professional | None | $707.95 | $912.01 | $1,230.27 |
Hally Health Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $2,818.38 | Professional | None | $741.31 | $1,148.15 | $2,818.38 |
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 $954.99 Median $977.24 Typical High $1,071.52 | Professional | None | $954.99 | $977.24 | $1,071.52 |
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 $1,174.90 Median $3,090.30 Typical High $9,332.54 | Facility | None | $1,174.90 | $3,090.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,698.24 | Professional | None | $707.95 | $912.01 | $1,698.24 |
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 $398.11 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $630.96 |
Where Illinois sits
The same service costs 3.6 times more in Vermont 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
VT $8,561MT $2,405
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.