How much rates vary
Facilitymedian $1,698 · 10th to 90th $676 to $4,169Professionalmedian $251 · 10th to 90th $195 to $389
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 $251.19 Median $1,819.70 Typical High $5,623.41 | Facility | None | $251.19 | $1,819.70 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $229.09 | Professional | None | $190.55 | $194.98 | $229.09 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $3,311.31 | Facility | None | $1,318.26 | $1,949.84 | $3,311.31 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $316.23 | Professional | None | $213.80 | $251.19 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $2,137.96 | Facility | None | $630.96 | $1,659.59 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $389.05 | Professional | None | $208.93 | $295.12 | $389.05 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $1,148.15 | Professional | None | $208.93 | $302.00 | $1,148.15 |
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 $234.42 Median $245.47 Typical High $263.03 | Professional | None | $234.42 | $245.47 | $263.03 |
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 $213.80 Median $302.00 Typical High $436.52 | Professional | None | $213.80 | $302.00 | $436.52 |
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 $95.50 Median $97.72 Typical High $107.15 | Professional | 52 · Reduced service | $95.50 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $38.02 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $147.91 Typical High $162.18 | Professional | 54 · Surgery only | $141.25 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $28.84 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $21.38 |
Where Illinois sits
The same service costs 6.8 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 $4,179MT $618
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.