How much rates vary
Facilitymedian $1,349 · 10th to 90th $490 to $5,888Professionalmedian $347 · 10th to 90th $257 to $501
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 $288.40 Median $1,621.81 Typical High $7,762.47 | Facility | None | $288.40 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $446.68 | Professional | None | $251.19 | $288.40 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,288.25 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,288.25 | $2,754.23 | $5,495.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $380.19 | Professional | None | $281.84 | $346.74 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $467.74 | Professional | None | $257.04 | $346.74 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $977.24 | Professional | None | $239.88 | $380.19 | $977.24 |
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 $263.03 Median $302.00 Typical High $338.84 | Professional | None | $263.03 | $302.00 | $338.84 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $562.34 | Professional | None | $257.04 | $380.19 | $562.34 |
5 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 $128.82 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $28.84 |
Where Illinois sits
The same service costs 7.3 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 $5,199MT $710
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.