How much rates vary
Facilitymedian $1,995 · 10th to 90th $741 to $5,248Professionalmedian $363 · 10th to 90th $209 to $631
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 $269.15 Median $1,348.96 Typical High $5,623.41 | Facility | None | $269.15 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $426.58 | Professional | None | $199.53 | $331.13 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,238.72 | $3,715.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $741.31 | Professional | None | $239.88 | $426.58 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,238.72 | Facility | None | $630.96 | $1,819.70 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $524.81 | Professional | None | $213.80 | $346.74 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $831.76 | Professional | None | $251.19 | $457.09 | $831.76 |
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 $234.42 Median $257.04 Typical High $446.68 | Professional | None | $234.42 | $257.04 | $446.68 |
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 $1,047.13 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $645.65 | Professional | None | $218.78 | $363.08 | $645.65 |
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 $100.00 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $100.00 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $39.81 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $245.47 Typical High $263.03 | Professional | 54 · Surgery only | $151.36 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $30.20 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.95 | $32.36 | $35.48 |
Where Illinois sits
The same service costs 7.9 times more in Oklahoma 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
OK $5,867MT $745
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.