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 $758.58 Median $4,168.69 Typical High $9,549.93 | Facility | None | $758.58 | $4,168.69 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $3,235.94 | Professional | None | $316.23 | $316.23 | $3,235.94 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $5,623.41 | Facility | None | $3,162.28 | $4,365.16 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $4,677.35 | Facility | None | $776.25 | $3,801.89 | $4,677.35 |
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 $1,174.90 Median $3,090.30 Typical High $8,912.51 | Facility | None | $1,174.90 | $3,090.30 | $8,912.51 |
United Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,202.26 | Professional | None | $562.34 | $831.76 | $1,202.26 |
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 $158.49 Median $158.49 Typical High $288.40 | Professional | 52 · Reduced service | $158.49 | $158.49 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $114.82 | Professional | 53 · Discontinued | $63.10 | $63.10 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $436.52 | Professional | 54 · Surgery only | $234.42 | $234.42 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $85.11 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $57.54 |
Where Illinois sits
The same service costs 10.2 times more in Texas than in New York. 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· 14th of 51
$1,738
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.