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 $758.58 Median $1,949.84 Typical High $5,888.44 | Facility | None | $758.58 | $1,949.84 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $5,623.41 | Professional | None | $64.57 | $64.57 | $5,623.41 |
BCBS Illinois Setting Facility Modifier None Typical Low $14,125.38 Median $17,378.01 Typical High $21,877.62 | Facility | None | $14,125.38 | $17,378.01 | $21,877.62 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,691.53 | Facility | None | $512.86 | $776.25 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $1,513.56 | Professional | None | $30.20 | $30.20 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,412.54 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,041.74 | Professional | None | $933.25 | $1,230.27 | $2,041.74 |
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 $32.36 Median $32.36 Typical High $512.86 | Professional | 52 · Reduced service | $32.36 | $32.36 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $204.17 | Professional | 53 · Discontinued | $12.88 | $12.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $758.58 | Professional | 54 · Surgery only | $48.98 | $48.98 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $154.88 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $154.88 |
Where Illinois sits
The same service costs 50.1 times more in Oklahoma than in North Carolina. 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
$1,259
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.