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 $524.81 Median $1,621.81 Typical High $7,762.47 | Facility | None | $524.81 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $676.08 | Professional | None | $457.09 | $524.81 | $676.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,290.87 Median $4,897.79 Typical High $10,000.00 | Facility | None | $2,290.87 | $4,897.79 | $10,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $851.14 | Professional | None | $512.86 | $630.96 | $851.14 |
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 $467.74 Median $630.96 Typical High $851.14 | Professional | None | $467.74 | $630.96 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,659.59 | Professional | None | $416.87 | $691.83 | $1,659.59 |
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 $467.74 Median $537.03 Typical High $602.56 | Professional | None | $467.74 | $537.03 | $602.56 |
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 $467.74 Median $691.83 Typical High $1,000.00 | Professional | None | $467.74 | $691.83 | $1,000.00 |
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 $229.09 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $52.48 | $52.48 |
Where Illinois sits
The same service costs 4.1 times more in Wisconsin 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· 23rd of 51
$661
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.