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 $812.83 Median $4,168.69 Typical High $10,471.29 | Facility | None | $812.83 | $4,168.69 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $1,023.29 | Professional | None | $269.15 | $269.15 | $1,023.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $22,387.21 Median $27,542.29 Typical High $33,113.11 | Facility | None | $22,387.21 | $27,542.29 | $33,113.11 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $26,302.68 Typical High $33,884.42 | Facility | None | $758.58 | $26,302.68 | $33,884.42 |
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 $1,659.59 Median $7,585.78 Typical High $25,703.96 | Facility | None | $1,659.59 | $7,585.78 | $25,703.96 |
United Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,412.54 | Professional | None | $602.56 | $954.99 | $1,412.54 |
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 $134.90 Median $134.90 Typical High $218.78 | Professional | 52 · Reduced service | $134.90 | $134.90 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $87.10 | Professional | 53 · Discontinued | $53.70 | $53.70 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $43.65 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $43.65 |
Where Illinois sits
The same service costs 27.5 times more in Oklahoma 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· 20th of 51
$1,862
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.