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 $851.14 Median $1,862.09 Typical High $7,762.47 | Facility | None | $851.14 | $1,862.09 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,412.54 | Professional | None | $812.83 | $954.99 | $1,412.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,265.80 Median $9,120.11 Typical High $18,197.01 | Facility | None | $4,265.80 | $9,120.11 | $18,197.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,202.26 | Professional | None | $891.25 | $1,096.48 | $1,202.26 |
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 $851.14 Median $1,096.48 Typical High $1,479.11 | Professional | None | $851.14 | $1,096.48 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $3,162.28 | Professional | None | $758.58 | $1,230.27 | $3,162.28 |
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 $851.14 Median $1,000.00 Typical High $1,122.02 | Professional | None | $851.14 | $1,000.00 | $1,122.02 |
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 $851.14 Median $1,230.27 Typical High $1,819.70 | Professional | None | $851.14 | $1,230.27 | $1,819.70 |
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 $426.58 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $95.50 |
Where Illinois sits
The same service costs 4.6 times more in Alaska 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· 25th of 51
$1,096
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.