How much rates vary
Facilitymedian $912 · 10th to 90th $363 to $3,162Professionalmedian $316 · 10th to 90th $191 to $661
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 $190.55 Median $616.60 Typical High $4,365.16 | Facility | None | $190.55 | $616.60 | $4,365.16 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $151.36 Typical High $309.03 | Facility | 53 · Discontinued | $69.18 | $151.36 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $478.63 | Professional | None | $181.97 | $302.00 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $93.33 Typical High $173.78 | Professional | 53 · Discontinued | $38.02 | $93.33 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | None | $169.82 | $186.21 | $186.21 |
BCBS Illinois Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $2,511.89 | Facility | None | $776.25 | $1,174.90 | $2,511.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $660.69 | Professional | None | $199.53 | $323.59 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $512.86 Typical High $1,096.48 | Facility | None | $478.63 | $512.86 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $194.98 Typical High $281.84 | Professional | 53 · Discontinued | $123.03 | $194.98 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $1,047.13 | Professional | None | $177.83 | $338.84 | $1,047.13 |
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 $213.80 Median $229.09 Typical High $457.09 | Professional | None | $213.80 | $229.09 | $457.09 |
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 $446.68 Median $1,047.13 Typical High $3,235.94 | Facility | None | $446.68 | $1,047.13 | $3,235.94 |
United Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $602.56 | Professional | None | $204.17 | $346.74 | $602.56 |
4 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 $91.20 Median $97.72 Typical High $173.78 | Professional | 52 · Reduced service | $91.20 | $97.72 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.39 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.20 | $22.39 | $34.67 |
Where Illinois sits
The same service costs 5.8 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 $4,478ME $766
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.