How much rates vary
Facilitymedian $933 · 10th to 90th $407 to $3,236Professionalmedian $138 · 10th to 90th $78 to $437
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 $263.03 Median $1,288.25 Typical High $5,623.41 | Facility | None | $263.03 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $204.17 Typical High $316.23 | Professional | None | $77.62 | $204.17 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $83.18 | Professional | None | $54.95 | $54.95 | $83.18 |
BCBS Illinois Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $1,737.80 | Facility | None | $398.11 | $588.84 | $1,737.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $87.10 Median $263.03 Typical High $407.38 | Professional | None | $87.10 | $263.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $524.81 Typical High $870.96 | Facility | None | $371.54 | $524.81 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $112.20 Typical High $467.74 | Professional | None | $51.29 | $112.20 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $323.59 Typical High $630.96 | Professional | None | $87.10 | $323.59 | $630.96 |
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 $89.13 Median $95.50 Typical High $354.81 | Professional | None | $89.13 | $95.50 | $354.81 |
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 $77.62 Median $190.55 Typical High $446.68 | Professional | None | $77.62 | $190.55 | $446.68 |
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 $38.90 Median $97.72 Typical High $141.25 | Professional | 52 · Reduced service | $38.90 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $15.49 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $57.54 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $11.75 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $19.50 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.76 | $19.50 | $28.18 |
Where Illinois sits
The same service costs 9.0 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 $4,579MT $507
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.