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 $977.24 Median $4,168.69 Typical High $10,471.29 | Facility | None | $977.24 | $4,168.69 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,348.96 | Professional | None | $660.69 | $660.69 | $1,348.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $12,882.50 Median $17,782.79 Typical High $27,542.29 | Facility | None | $12,882.50 | $17,782.79 | $27,542.29 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $812.83 Typical High $6,760.83 | Facility | None | $512.86 | $812.83 | $6,760.83 |
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 $1,174.90 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,737.80 | $2,511.89 |
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 $331.13 Median $331.13 Typical High $537.03 | Professional | 52 · Reduced service | $331.13 | $331.13 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | 53 · Discontinued | $131.83 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $107.15 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $107.15 |
Where Illinois sits
The same service costs 18.2 times more in California 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· 21st of 51
$2,291
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.