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 $186.21 Median $186.21 Typical High $302.00 | Professional | None | $186.21 | $186.21 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
BCBS Illinois Setting Facility Modifier None Typical Low $602.56 Median $851.14 Typical High $1,096.48 | Facility | None | $602.56 | $851.14 | $1,096.48 |
BCBS Illinois Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $954.99 | Facility | None | $537.03 | $758.58 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,548.82 | Professional | None | $446.68 | $446.68 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $380.19 | Professional | None | $181.97 | $245.47 | $380.19 |
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 $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $724.44 | Professional | None | $169.82 | $309.03 | $724.44 |
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 $91.20 Median $91.20 Typical High $147.91 | Professional | 52 · Reduced service | $91.20 | $91.20 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $58.88 | Professional | 53 · Discontinued | $37.15 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $44.67 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $29.51 |
Where Illinois sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 50th of 51
$257
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.