How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $8,913Professionalmedian $759 · 10th to 90th $372 to $1,380
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 $758.58 Median $3,162.28 Typical High $9,549.93 | Facility | None | $758.58 | $3,162.28 | $9,549.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $676.08 Median $758.58 Typical High $1,995.26 | Professional | None (both parts) | $676.08 | $758.58 | $1,995.26 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $275.42 Typical High $389.05 | Professional | 26 · Professional part | $239.88 | $275.42 | $389.05 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $426.58 Median $489.78 Typical High $707.95 | Professional | TC · Technical part | $426.58 | $489.78 | $707.95 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 26 · Professional part | $275.42 | $275.42 | $275.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,089.30 Median $4,897.79 Typical High $7,585.78 | Facility | None | $2,089.30 | $4,897.79 | $7,585.78 |
BCBS Illinois Setting Professional Modifier None (both parts) Typical Low $257.04 Median $660.69 Typical High $1,230.27 | Professional | None (both parts) | $257.04 | $660.69 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,570.88 Typical High $13,803.84 | Facility | None | $524.81 | $4,570.88 | $13,803.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $371.54 Median $776.25 Typical High $1,258.93 | Professional | None (both parts) | $371.54 | $776.25 | $1,258.93 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | 26 · Professional part | $245.47 | $302.00 | $436.52 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $97.72 Median $501.19 Typical High $812.83 | Professional | TC · Technical part | $97.72 | $501.19 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $2,630.27 | Professional | None | $549.54 | $851.14 | $2,630.27 |
Hally Health Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $331.13 Typical High $954.99 | Professional | 26 · Professional part | $239.88 | $331.13 | $954.99 |
Hally Health Setting Professional Modifier TC · Technical part Typical Low $338.84 Median $537.03 Typical High $1,445.44 | Professional | TC · Technical part | $338.84 | $537.03 | $1,445.44 |
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 (both parts) Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | None (both parts) | $741.31 | $741.31 | $831.76 |
Molina Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,235.94 Typical High $8,317.64 | Facility | None | $1,202.26 | $3,235.94 | $8,317.64 |
United Setting Professional Modifier None (both parts) Typical Low $660.69 Median $1,047.13 Typical High $1,548.82 | Professional | None (both parts) | $660.69 | $1,047.13 | $1,548.82 |
United Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $363.08 Typical High $524.81 | Professional | 26 · Professional part | $234.42 | $363.08 | $524.81 |
United Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $707.95 Typical High $1,000.00 | Professional | TC · Technical part | $467.74 | $707.95 | $1,000.00 |
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 $331.13 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $75.86 |
Where Illinois sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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.
Illinois· 28th of 51
$1,000
WI $2,630TX $603
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.