How much rates vary
Facilitymedian $1,072 · 10th to 90th $479 to $3,236Professionalmedian $302 · 10th to 90th $158 to $525
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 $204.17 Median $588.84 Typical High $4,677.35 | Facility | None | $204.17 | $588.84 | $4,677.35 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $131.83 Typical High $295.12 | Facility | 53 · Discontinued | $63.10 | $131.83 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $389.05 | Professional | None | $158.49 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $79.43 Typical High $158.49 | Professional | 53 · Discontinued | $31.62 | $79.43 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,737.80 | Facility | None | $776.25 | $1,148.15 | $1,737.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $478.63 | Professional | None | $173.78 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $933.25 Typical High $1,202.26 | Facility | None | $478.63 | $933.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $562.34 | Professional | None | $181.97 | $309.03 | $562.34 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $338.84 | Professional | 53 · Discontinued | $154.88 | $194.98 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $407.38 Typical High $1,096.48 | Professional | None | $194.98 | $407.38 | $1,096.48 |
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 $181.97 Median $194.98 Typical High $426.58 | Professional | None | $181.97 | $194.98 | $426.58 |
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 $4,073.80 | Facility | None | $676.08 | $1,513.56 | $4,073.80 |
United Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $537.03 | Professional | None | $169.82 | $316.23 | $537.03 |
4 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 $79.43 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $79.43 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $239.88 | Professional | 54 · Surgery only | $120.23 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $23.99 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $31.62 |
Where Illinois sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.