How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,380 to $11,482Professionalmedian $1,230 · 10th to 90th $912 to $2,188
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 $912.01 Median $3,890.45 Typical High $14,125.38 | Facility | None | $912.01 | $3,890.45 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,584.89 | Professional | None | $912.01 | $912.01 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $12,882.50 | Facility | None | $4,570.88 | $6,760.83 | $12,882.50 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,513.56 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,380.38 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,202.26 | $1,862.09 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $5,011.87 | Professional | None | $1,023.29 | $1,621.81 | $5,011.87 |
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 $1,202.26 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,288.25 | $1,412.54 |
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 $1,288.25 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 $1,023.29 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,318.26 | $2,238.72 |
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 $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $707.95 |
Where Illinois sits
The same service costs 3.6 times more in Alaska 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
AK $11,248MT $3,134
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.