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 $331.13 Median $1,445.44 Typical High $5,623.41 | Facility | None | $331.13 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $125.89 | Professional | None | $69.18 | $85.11 | $125.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $1,995.26 | Facility | None | $467.74 | $1,000.00 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $151.36 | Professional | None | $85.11 | $114.82 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $562.34 | Professional | None | $83.18 | $128.82 | $562.34 |
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 $93.33 Median $97.72 Typical High $104.71 | Professional | None | $93.33 | $97.72 | $104.71 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $181.97 | Professional | None | $83.18 | $117.49 | $181.97 |
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 $34.67 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $34.67 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $18.62 | Professional | 53 · Discontinued | $14.13 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $64.57 Typical High $69.18 | Professional | 54 · Surgery only | $52.48 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $10.47 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $9.12 |
Where Illinois sits
The same service costs 6.5 times more in Tennessee 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· 35th of 51
$123
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.