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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $1,023.29 | Professional | None | $208.93 | $208.93 | $1,023.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $5,623.41 | Facility | None | $3,162.28 | $4,365.16 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $4,677.35 | Facility | None | $758.58 | $3,715.35 | $4,677.35 |
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 $8,912.51 | Facility | None | $1,174.90 | $3,090.30 | $8,912.51 |
United Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,318.26 | Professional | None | $575.44 | $891.25 | $1,318.26 |
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 $104.71 Median $104.71 Typical High $257.04 | Professional | 52 · Reduced service | $104.71 | $104.71 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $102.33 | Professional | 53 · Discontinued | $41.69 | $41.69 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $346.74 | Professional | 54 · Surgery only | $158.49 | $158.49 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $75.86 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $51.29 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $51.29 |
Where Illinois sits
The same service costs 10.2 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· 18th of 51
$1,445
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.