How much rates vary
Facilitymedian $1,380 · 10th to 90th $708 to $4,074Professionalmedian $316 · 10th to 90th $245 to $427
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 $245.47 Median $251.19 Typical High $363.08 | Professional | None | $245.47 | $251.19 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,754.23 | Facility | None | $1,000.00 | $1,445.44 | $2,754.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $389.05 | Professional | None | $263.03 | $316.23 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,548.82 | Facility | None | $758.58 | $1,202.26 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $407.38 | Professional | None | $263.03 | $338.84 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $1,584.89 | Professional | None | $263.03 | $371.54 | $1,584.89 |
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 $288.40 Median $316.23 Typical High $338.84 | Professional | None | $288.40 | $316.23 | $338.84 |
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 $269.15 Median $323.59 Typical High $512.86 | Professional | None | $269.15 | $323.59 | $512.86 |
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 $123.03 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $25.12 |
Where Illinois sits
The same service costs 5.6 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 $4,320MT $769
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.