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 $380.19 Median $1,548.82 Typical High $5,623.41 | Facility | None | $380.19 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $316.23 | Professional | None | $128.82 | $128.82 | $316.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,311.31 | Facility | None | $2,187.76 | $2,691.53 | $3,311.31 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | None | $213.80 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,691.53 Typical High $3,311.31 | Facility | None | $776.25 | $2,691.53 | $3,311.31 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $457.09 | Professional | None | $208.93 | $338.84 | $457.09 |
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 $275.42 Median $281.84 Typical High $309.03 | Professional | None | $275.42 | $281.84 | $309.03 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $10,000.00 | Facility | None | $1,288.25 | $4,073.80 | $10,000.00 |
United Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $467.74 | Professional | None | $213.80 | $288.40 | $467.74 |
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 $64.57 Median $64.57 Typical High $107.15 | Professional | 52 · Reduced service | $64.57 | $64.57 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $43.65 | Professional | 53 · Discontinued | $25.70 | $25.70 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $162.18 | Professional | 54 · Surgery only | $95.50 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $32.36 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $21.38 |
Where Illinois sits
The same service costs 19.5 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· 22nd of 51
$389
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.