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 $831.76 Median $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $2,344.23 | Professional | None | $870.96 | $870.96 | $2,344.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $5,128.61 | Facility | None | $3,235.94 | $4,073.80 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $4,897.79 | Facility | None | $758.58 | $3,801.89 | $4,897.79 |
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 $7,943.28 | Facility | None | $1,174.90 | $3,090.30 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $4,365.16 | Professional | None | $1,949.84 | $3,019.95 | $4,365.16 |
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 $436.52 Median $436.52 Typical High $758.58 | Professional | 52 · Reduced service | $436.52 | $436.52 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $309.03 | Professional | 53 · Discontinued | $173.78 | $173.78 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,148.15 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $229.09 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $151.36 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $151.36 |
Where Illinois sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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· 12th of 51
$3,020
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.