How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $3,890Professionalmedian $339 · 10th to 90th $195 to $794
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 $245.47 Median $870.96 Typical High $4,677.35 | Facility | None | $245.47 | $870.96 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $645.65 | Professional | None | $194.98 | $363.08 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $467.74 | Professional | None | $104.71 | $229.09 | $467.74 |
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 $208.93 Median $501.19 Typical High $724.44 | Professional | None | $208.93 | $501.19 | $724.44 |
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 $218.78 Median $316.23 Typical High $851.14 | Professional | None | $218.78 | $316.23 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $588.84 Typical High $1,258.93 | Professional | None | $245.47 | $588.84 | $1,258.93 |
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 $229.09 Median $245.47 Typical High $630.96 | Professional | None | $229.09 | $245.47 | $630.96 |
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 $208.93 Median $354.81 Typical High $851.14 | Professional | None | $208.93 | $354.81 | $851.14 |
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 $165.96 Typical High $245.47 | Professional | 52 · Reduced service | $97.72 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $38.90 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $269.15 Typical High $371.54 | Professional | 54 · Surgery only | $147.91 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $50.12 Typical High $74.13 | Professional | 55 · Aftercare only | $29.51 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.11 Typical High $48.98 | Professional | 56 · Pre-op care only | $19.50 | $33.11 | $48.98 |
Where Illinois sits
The same service costs 4.1 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 $4,142MT $1,002
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.