How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,585 to $10,233Professionalmedian $479 · 10th to 90th $309 to $832
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 $1,148.15 Median $5,623.41 Typical High $12,589.25 | Facility | None | $1,148.15 | $5,623.41 | $12,589.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $1,023.29 Typical High $12,302.69 | Professional | None (both parts) | $309.03 | $1,023.29 | $12,302.69 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 26 · Professional part | $309.03 | $331.13 | $331.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $7,762.47 | Facility | None | $3,715.35 | $5,248.07 | $7,762.47 |
BCBS Illinois Setting Professional Modifier None (both parts) Typical Low $316.23 Median $478.63 Typical High $575.44 | Professional | None (both parts) | $316.23 | $478.63 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,041.74 Typical High $6,760.83 | Facility | None | $524.81 | $2,041.74 | $6,760.83 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $407.38 Typical High $537.03 | Professional | 26 · Professional part | $316.23 | $407.38 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $7,585.78 Typical High $12,022.64 | Professional | None | $125.89 | $7,585.78 | $12,022.64 |
Hally Health Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $398.11 Typical High $707.95 | Professional | 26 · Professional part | $302.00 | $398.11 | $707.95 |
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 26 · Professional part Typical Low $316.23 Median $346.74 Typical High $371.54 | Professional | 26 · Professional part | $316.23 | $346.74 | $371.54 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $10,964.78 | Facility | None | $1,318.26 | $4,073.80 | $10,964.78 |
United Setting Professional Modifier None (both parts) Typical Low $309.03 Median $467.74 Typical High $691.83 | Professional | None (both parts) | $309.03 | $467.74 | $691.83 |
United Setting Professional Modifier 26 · Professional part Typical Low $309.03 Median $467.74 Typical High $691.83 | Professional | 26 · Professional part | $309.03 | $467.74 | $691.83 |
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 $154.88 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $33.11 |
Hally Health Setting Professional Modifier TC · Technical part Typical Low $5,754.40 Median $7,762.47 Typical High $12,022.64 | Professional | TC · Technical part | $5,754.40 | $7,762.47 | $12,022.64 |
Where Illinois sits
The same service costs 23.4 times more in Colorado than in Kentucky. 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.
Illinois· 30th of 51
$912
CO $6,761KY $288
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.