How much rates vary
Facilitymedian $1,995 · 10th to 90th $646 to $6,310Professionalmedian $575 · 10th to 90th $200 to $1,202
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 $229.09 Median $1,862.09 Typical High $7,244.36 | Facility | None | $229.09 | $1,862.09 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $562.34 Typical High $741.31 | Professional | None | $194.98 | $562.34 | $741.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $691.83 Median $1,096.48 Typical High $5,011.87 | Facility | None | $691.83 | $1,096.48 | $5,011.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $199.53 Median $602.56 Typical High $1,202.26 | Professional | None | $199.53 | $602.56 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $1,071.52 | Facility | None | $478.63 | $831.76 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $446.68 Typical High $1,047.13 | Professional | None | $204.17 | $446.68 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $741.31 Typical High $1,445.44 | Professional | None | $223.87 | $741.31 | $1,445.44 |
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 $208.93 Median $223.87 Typical High $741.31 | Professional | None | $208.93 | $223.87 | $741.31 |
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 $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $208.93 Median $588.84 Typical High $1,230.27 | Professional | None | $208.93 | $588.84 | $1,230.27 |
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 $97.72 Median $213.80 Typical High $338.84 | Professional | 52 · Reduced service | $97.72 | $213.80 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $85.11 Typical High $138.04 | Professional | 53 · Discontinued | $38.90 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $316.23 Typical High $512.86 | Professional | 54 · Surgery only | $147.91 | $316.23 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $63.10 Typical High $102.33 | Professional | 55 · Aftercare only | $29.51 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $42.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $19.50 | $42.66 | $69.18 |
Where Illinois sits
The same service costs 6.9 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 $7,377MT $1,063
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.