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 $251.19 Median $1,949.84 Typical High $7,762.47 | Facility | None | $251.19 | $1,949.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $251.19 | Professional | None | $123.03 | $223.87 | $251.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,737.80 Median $3,019.95 Typical High $5,623.41 | Facility | None | $1,737.80 | $3,019.95 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,951.21 Typical High $3,890.45 | Facility | None | $776.25 | $2,951.21 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $478.63 | Professional | None | $151.36 | $275.42 | $478.63 |
Hally Health Setting Professional Modifier None Typical Low $169.82 Median $354.81 Typical High $758.58 | Professional | None | $169.82 | $354.81 | $758.58 |
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 $165.96 Median $181.97 Typical High $363.08 | Professional | None | $165.96 | $181.97 | $363.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $9,332.54 | Facility | None | $1,174.90 | $3,090.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $524.81 | Professional | None | $144.54 | $269.15 | $524.81 |
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 $61.66 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $61.66 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $24.55 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $169.82 Typical High $190.55 | Professional | 54 · Surgery only | $91.20 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $18.62 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $22.39 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.30 | $22.39 | $25.12 |
Where Illinois sits
The same service costs 5.8 times more in Alaska than in Hawaii. 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· 23rd of 51
$302
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.