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 $43.65 Median $1,862.09 Typical High $7,762.47 | Facility | None | $43.65 | $1,862.09 | $7,762.47 |
Aetna Setting Professional Modifier None (both parts) Typical Low $43.65 Median $43.65 Typical High $72.44 | Professional | None (both parts) | $43.65 | $43.65 | $72.44 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $16.22 Median $16.22 Typical High $27.54 | Professional | 26 · Professional part | $16.22 | $16.22 | $27.54 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $27.54 Typical High $42.66 | Professional | TC · Technical part | $27.54 | $27.54 | $42.66 |
BCBS Illinois Setting Facility Modifier None Typical Low $47.86 Median $53.70 Typical High $64.57 | Facility | None | $47.86 | $53.70 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $114.82 | Facility | None | $50.12 | $79.43 | $114.82 |
Cigna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None (both parts) | $89.13 | $89.13 | $89.13 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $346.74 | Professional | None | $100.00 | $151.36 | $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 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,513.56 Typical High $2,511.89 | Professional | None (both parts) | $1,513.56 | $1,513.56 | $2,511.89 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $100.00 | Facility | None | $89.13 | $89.13 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $72.44 Median $95.50 Typical High $154.88 | Professional | None (both parts) | $72.44 | $95.50 | $154.88 |
United Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $36.31 Typical High $67.61 | Professional | 26 · Professional part | $28.84 | $36.31 | $67.61 |
United Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $56.23 Typical High $93.33 | Professional | TC · Technical part | $42.66 | $56.23 | $93.33 |
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 $21.88 Median $21.88 Typical High $34.67 | Professional | 52 · Reduced service | $21.88 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $14.13 | Professional | 53 · Discontinued | $8.71 | $8.71 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $52.48 | Professional | 54 · Surgery only | $33.11 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $10.47 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $7.08 |
Where Illinois sits
The same service costs 4.4 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· 24th of 51
$79.43
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.