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 $380.19 Median $1,548.82 Typical High $5,623.41 | Facility | None | $380.19 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $316.23 | Professional | None | $79.43 | $79.43 | $316.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,047.13 | Facility | None | $467.74 | $645.65 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $616.60 Typical High $831.76 | Facility | None | $436.52 | $616.60 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $27.54 Median $38.02 Typical High $64.57 | Professional | None | $27.54 | $38.02 | $64.57 |
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 $30.90 Median $33.11 Typical High $35.48 | Professional | None | $30.90 | $33.11 | $35.48 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $316.23 | Professional | None | $95.50 | $190.55 | $316.23 |
4 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 $39.81 Median $39.81 Typical High $75.86 | Professional | 52 · Reduced service | $39.81 | $39.81 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $30.20 | Professional | 53 · Discontinued | $15.85 | $15.85 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $22.91 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $15.14 |
Where Illinois sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 35th of 51
$245
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.