How much rates vary
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 $870.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $870.96 | $5,011.87 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $3,801.89 | Professional | None | $223.87 | $223.87 | $3,801.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,471.29 Median $12,022.64 Typical High $15,848.93 | Facility | None | $10,471.29 | $12,022.64 | $15,848.93 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $12,589.25 Typical High $16,218.10 | Facility | None | $776.25 | $12,589.25 | $16,218.10 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $346.74 | Professional | None | $100.00 | $125.89 | $346.74 |
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 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $7,585.78 Typical High $19,498.45 | Facility | None | $1,659.59 | $7,585.78 | $19,498.45 |
United Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $125.89 | Professional | None | $54.95 | $79.43 | $125.89 |
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 $109.65 Median $112.20 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $251.19 | Professional | 54 · Surgery only | $165.96 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.39 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $22.39 | $33.88 |
Where Illinois sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 19th of 51
$2,239
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.