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 $63.10 Median $1,862.09 Typical High $7,762.47 | Facility | None | $63.10 | $1,862.09 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $3,235.94 | Professional | None | $63.10 | $95.50 | $3,235.94 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $4,073.80 | Facility | None | $2,951.21 | $3,311.31 | $4,073.80 |
Hally Health Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $218.78 | Professional | None | $109.65 | $154.88 | $218.78 |
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 $112.20 Median $141.25 Typical High $158.49 | Professional | None | $112.20 | $141.25 | $158.49 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,981.07 Typical High $7,943.28 | Facility | None | $1,698.24 | $3,981.07 | $7,943.28 |
United Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $245.47 | Professional | None | $97.72 | $151.36 | $245.47 |
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 $31.62 Median $31.62 Typical High $52.48 | Professional | 52 · Reduced service | $31.62 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $21.38 | Professional | 53 · Discontinued | $12.59 | $12.59 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $46.77 Typical High $77.62 | Professional | 54 · Surgery only | $46.77 | $46.77 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $15.85 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $10.47 |
Where Illinois sits
The same service costs 51.3 times more in Oklahoma than in Kentucky. 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· 27th of 51
$182
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.