How much rates vary
Facilitymedian $1,778 · 10th to 90th $224 to $4,169Professionalmedian $166 · 10th to 90th $74 to $316
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 $85.11 Median $295.12 Typical High $4,677.35 | Facility | None | $85.11 | $295.12 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $151.36 Typical High $245.47 | Professional | None | $72.44 | $151.36 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $245.47 | Professional | None | $40.74 | $69.18 | $245.47 |
BCBS Illinois Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $4,168.69 | Facility | None | $954.99 | $2,290.87 | $4,168.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $331.13 | Professional | None | $77.62 | $177.83 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,238.72 Typical High $2,818.38 | Facility | None | $741.31 | $2,238.72 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $309.03 | Professional | None | $81.28 | $177.83 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $229.09 Typical High $512.86 | Professional | None | $100.00 | $229.09 | $512.86 |
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 $89.13 Median $93.33 Typical High $229.09 | Professional | None | $89.13 | $93.33 | $229.09 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $309.03 | Professional | None | $81.28 | $162.18 | $309.03 |
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 $35.48 Median $75.86 Typical High $85.11 | Professional | 52 · Reduced service | $35.48 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $30.20 Typical High $33.88 | Professional | 53 · Discontinued | $14.13 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $112.20 Typical High $125.89 | Professional | 54 · Surgery only | $53.70 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $22.39 Typical High $25.12 | Professional | 55 · Aftercare only | $10.72 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $15.14 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.08 | $15.14 | $16.98 |
Where Illinois sits
The same service costs 9.7 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 $4,351MT $447
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.