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 $3,235.94 Typical High $7,762.47 | Facility | None | $758.58 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Professional | None | $501.19 | $501.19 | $1,023.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,762.47 Median $10,715.19 Typical High $15,848.93 | Facility | None | $7,762.47 | $10,715.19 | $15,848.93 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $11,748.98 | Facility | None | $758.58 | $9,332.54 | $11,748.98 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,041.74 | Professional | None | $891.25 | $1,412.54 | $2,041.74 |
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 |
Hally Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,174.90 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $9,772.37 | Facility | None | $1,174.90 | $3,090.30 | $9,772.37 |
United Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $851.14 | Professional | None | $380.19 | $537.03 | $851.14 |
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 $251.19 Median $251.19 Typical High $371.54 | Professional | 52 · Reduced service | $251.19 | $251.19 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $151.36 | Professional | 53 · Discontinued | $100.00 | $100.00 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $562.34 | Professional | 54 · Surgery only | $371.54 | $371.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $112.20 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $75.86 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $75.86 |
Where Illinois sits
The same service costs 14.8 times more in Texas 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.
Illinois· 21st of 51
$1,413
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.