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 $354.81 Median $1,621.81 Typical High $7,762.47 | Facility | None | $354.81 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $537.03 | Professional | None | $295.12 | $354.81 | $537.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $6,760.83 | Facility | None | $1,584.89 | $3,388.44 | $6,760.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $467.74 | Professional | None | $346.74 | $416.87 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $562.34 | Professional | None | $316.23 | $416.87 | $562.34 |
Hally Health Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $1,445.44 | Professional | None | $288.40 | $457.09 | $1,445.44 |
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 $309.03 Median $371.54 Typical High $416.87 | Professional | None | $309.03 | $371.54 | $416.87 |
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 $316.23 Median $436.52 Typical High $676.08 | Professional | None | $316.23 | $436.52 | $676.08 |
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 $154.88 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $154.88 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $63.10 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $35.48 |
Where Illinois sits
The same service costs 3.9 times more in Wisconsin 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
$427
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.