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 $575.44 Median $1,621.81 Typical High $7,762.47 | Facility | None | $575.44 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $741.31 | Professional | None | $512.86 | $575.44 | $741.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $5,370.32 Typical High $10,964.78 | Facility | None | $2,511.89 | $5,370.32 | $10,964.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $954.99 | Professional | None | $562.34 | $691.83 | $954.99 |
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 $512.86 Median $707.95 Typical High $933.25 | Professional | None | $512.86 | $707.95 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $2,041.74 | Professional | None | $457.09 | $758.58 | $2,041.74 |
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 $512.86 Median $602.56 Typical High $660.69 | Professional | None | $512.86 | $602.56 | $660.69 |
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 $512.86 Median $776.25 Typical High $1,096.48 | Professional | None | $512.86 | $776.25 | $1,096.48 |
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 $257.04 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $57.54 |
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· 23rd of 51
$724
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.