How much rates vary
Facilitymedian $1,549 · 10th to 90th $617 to $3,548Professionalmedian $141 · 10th to 90th $71 to $851
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 $89.13 Median $933.25 Typical High $5,370.32 | Facility | None | $89.13 | $933.25 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $489.78 Typical High $645.65 | Professional | None | $70.79 | $489.78 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $851.14 Median $1,659.59 Typical High $2,754.23 | Facility | None | $851.14 | $1,659.59 | $2,754.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $74.13 Median $316.23 Typical High $724.44 | Professional | None | $74.13 | $316.23 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $2,137.96 | Facility | None | $776.25 | $1,621.81 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $870.96 | Professional | None | $77.62 | $114.82 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $91.20 Median $645.65 Typical High $977.24 | Professional | None | $91.20 | $645.65 | $977.24 |
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 $81.28 Median $87.10 Typical High $724.44 | Professional | None | $81.28 | $87.10 | $724.44 |
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 $75.86 Median $269.15 Typical High $1,023.29 | Professional | None | $75.86 | $269.15 | $1,023.29 |
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 $35.48 Median $229.09 Typical High $295.12 | Professional | 52 · Reduced service | $35.48 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $14.45 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $338.84 Typical High $436.52 | Professional | 54 · Surgery only | $53.70 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $10.72 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $7.08 | $45.71 | $58.88 |
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 $4,728MT $843
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.