How much rates vary
Facilitymedian $3,236 · 10th to 90th $724 to $9,550Professionalmedian $363 · 10th to 90th $288 to $513
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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $407.38 | Professional | None | $281.84 | $295.12 | $407.38 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,467.37 Median $7,762.47 Typical High $10,000.00 | Facility | None | $3,467.37 | $7,762.47 | $10,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $446.68 | Professional | None | $302.00 | $363.08 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $7,585.78 Typical High $10,000.00 | Facility | None | $776.25 | $7,585.78 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $467.74 | Professional | None | $309.03 | $416.87 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $1,698.24 | Professional | None | $302.00 | $426.58 | $1,698.24 |
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 $338.84 Median $363.08 Typical High $389.05 | Professional | None | $338.84 | $363.08 | $389.05 |
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 $309.03 Median $389.05 Typical High $588.84 | Professional | None | $309.03 | $389.05 | $588.84 |
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 $141.25 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $29.51 |
Where Illinois sits
The same service costs 7.8 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 $7,005MT $893
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.