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 $691.83 Median $1,862.09 Typical High $5,888.44 | Facility | None | $691.83 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $125.89 Typical High $389.05 | Professional | None | $19.95 | $125.89 | $389.05 |
BCBS Illinois Setting Facility Modifier None Typical Low $165.96 Median $208.93 Typical High $281.84 | Facility | None | $165.96 | $208.93 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $223.87 Typical High $398.11 | Facility | None | $208.93 | $223.87 | $398.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $138.04 Median $457.09 Typical High $1,949.84 | Facility | None | $138.04 | $457.09 | $1,949.84 |
United Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $41.69 | Professional | None | $22.39 | $26.30 | $41.69 |
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 $10.00 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $10.00 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $3.98 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $15.14 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $3.02 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $2.00 | $12.59 | $12.59 |
Where Illinois sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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· 36th of 51
$30.20
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.