How much rates vary
Facilitymedian $2,754 · 10th to 90th $631 to $5,754Professionalmedian $447 · 10th to 90th $251 to $2,344
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 $257.04 Median $1,318.26 Typical High $5,495.41 | Facility | None | $257.04 | $1,318.26 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $1,698.24 | Professional | None | $229.09 | $407.38 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $1,202.26 | Professional | None | $194.98 | $281.84 | $1,202.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $5,370.32 | Facility | None | $2,570.40 | $3,467.37 | $5,370.32 |
BCBS Illinois Setting Professional Modifier None Typical Low $275.42 Median $549.54 Typical High $2,511.89 | Professional | None | $275.42 | $549.54 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,162.28 Typical High $4,168.69 | Facility | None | $741.31 | $3,162.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $2,041.74 | Professional | None | $269.15 | $363.08 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $1,479.11 Typical High $2,884.03 | Professional | None | $309.03 | $1,479.11 | $2,884.03 |
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 $269.15 Median $295.12 Typical High $1,621.81 | Professional | None | $269.15 | $295.12 | $1,621.81 |
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 $1,047.13 Median $2,754.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,754.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $2,511.89 | Professional | None | $269.15 | $446.68 | $2,511.89 |
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 $107.15 Median $213.80 Typical High $645.65 | Professional | 52 · Reduced service | $107.15 | $213.80 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $87.10 Typical High $257.04 | Professional | 53 · Discontinued | $42.66 | $87.10 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $323.59 Typical High $954.99 | Professional | 54 · Surgery only | $162.18 | $323.59 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $64.57 Typical High $190.55 | Professional | 55 · Aftercare only | $32.36 | $64.57 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $43.65 Typical High $128.82 | Professional | 56 · Pre-op care only | $21.38 | $43.65 | $128.82 |
Where Illinois sits
The same service costs 4.3 times more in Vermont than in Maine. 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
VT $8,043ME $1,891
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.