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 $223.87 Median $1,621.81 Typical High $7,762.47 | Facility | None | $223.87 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $295.12 | Professional | None | $204.17 | $223.87 | $295.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $4,265.80 | Facility | None | $1,000.00 | $2,137.96 | $4,265.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $371.54 | Professional | None | $223.87 | $269.15 | $371.54 |
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 $199.53 Median $281.84 Typical High $371.54 | Professional | None | $199.53 | $281.84 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $831.76 | Professional | None | $190.55 | $302.00 | $831.76 |
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 $204.17 Median $234.42 Typical High $263.03 | Professional | None | $204.17 | $234.42 | $263.03 |
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 $204.17 Median $302.00 Typical High $436.52 | Professional | None | $204.17 | $302.00 | $436.52 |
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 $102.33 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $22.39 |
Where Illinois sits
The same service costs 4.3 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· 28th of 51
$309
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.