How much rates vary
Facilitymedian $813 · 10th to 90th $245 to $2,512Professionalmedian $174 · 10th to 90th $110 to $288
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 $138.04 Median $346.74 Typical High $4,677.35 | Facility | None | $138.04 | $346.74 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $234.42 | Professional | None | $107.15 | $151.36 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $151.36 | Professional | None | $89.13 | $107.15 | $151.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $1,412.54 | Facility | None | $588.84 | $870.96 | $1,412.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $316.23 | Professional | None | $128.82 | $194.98 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $707.95 Typical High $912.01 | Facility | None | $467.74 | $707.95 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $275.42 | Professional | None | $120.23 | $181.97 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $758.58 | Professional | None | $144.54 | $229.09 | $758.58 |
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 $134.90 Median $141.25 Typical High $223.87 | Professional | None | $134.90 | $141.25 | $223.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $245.47 | Professional | None | $33.11 | $33.11 | $245.47 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,019.95 | Facility | None | $446.68 | $1,047.13 | $3,019.95 |
United Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $295.12 | Professional | None | $112.20 | $173.78 | $295.12 |
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 $52.48 Median $67.61 Typical High $81.28 | Professional | 52 · Reduced service | $52.48 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $20.89 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $79.43 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $16.22 |
Where Illinois sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.