How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,202 to $16,596Professionalmedian $4,266 · 10th to 90th $479 to $8,710
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 $549.54 Median $2,290.87 Typical High $6,309.57 | Facility | None | $549.54 | $2,290.87 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $3,388.44 Typical High $5,623.41 | Professional | None | $446.68 | $3,388.44 | $5,623.41 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $4,466.84 | Professional | None | $512.86 | $512.86 | $4,466.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,762.47 Median $12,882.50 Typical High $16,595.87 | Facility | None | $7,762.47 | $12,882.50 | $16,595.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $478.63 Median $1,995.26 Typical High $8,709.64 | Professional | None | $478.63 | $1,995.26 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $12,022.64 Typical High $15,488.17 | Facility | None | $776.25 | $12,022.64 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,148.15 Typical High $6,918.31 | Professional | None | $489.78 | $1,148.15 | $6,918.31 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $5,623.41 Typical High $9,772.37 | Professional | None | $501.19 | $5,623.41 | $9,772.37 |
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 $489.78 Median $537.03 Typical High $5,623.41 | Professional | None | $489.78 | $537.03 | $5,623.41 |
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 $1,659.59 Median $7,585.78 Typical High $22,908.68 | Facility | None | $1,659.59 | $7,585.78 | $22,908.68 |
United Setting Professional Modifier None Typical Low $501.19 Median $4,265.80 Typical High $9,332.54 | Professional | None | $501.19 | $4,265.80 | $9,332.54 |
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 $234.42 Median $676.08 Typical High $2,691.53 | Professional | 52 · Reduced service | $234.42 | $676.08 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $269.15 Typical High $1,071.52 | Professional | 53 · Discontinued | $93.33 | $269.15 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $1,000.00 Typical High $3,981.07 | Professional | 54 · Surgery only | $354.81 | $1,000.00 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $199.53 Typical High $812.83 | Professional | 55 · Aftercare only | $70.79 | $199.53 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $134.90 Typical High $537.03 | Professional | 56 · Pre-op care only | $46.77 | $134.90 | $537.03 |
Where Illinois sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.