How much rates vary
Facilitymedian $1,349 · 10th to 90th $661 to $3,311Professionalmedian $214 · 10th to 90th $170 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 $218.78 Median $1,380.38 Typical High $5,623.41 | Facility | None | $218.78 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $245.47 | Professional | None | $165.96 | $173.78 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $204.17 | Professional | None | $147.91 | $204.17 | $204.17 |
BCBS Illinois Setting Facility Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,187.76 | Facility | None | $977.24 | $1,445.44 | $2,187.76 |
BCBS Illinois Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $269.15 | Professional | None | $181.97 | $213.80 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,202.26 Typical High $1,659.59 | Facility | None | $501.19 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $302.00 | Professional | None | $181.97 | $251.19 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $1,047.13 | Professional | None | $177.83 | $263.03 | $1,047.13 |
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 $199.53 Median $213.80 Typical High $229.09 | Professional | None | $199.53 | $213.80 | $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 $4,073.80 | Facility | None | $676.08 | $1,513.56 | $4,073.80 |
United Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $371.54 | Professional | None | $181.97 | $269.15 | $371.54 |
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 $83.18 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $33.11 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.60 | $17.38 | $17.38 |
Where Illinois sits
The same service costs 7.7 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 $4,047MT $526
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.