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 $1,905.46 Typical High $7,762.47 | Facility | None | $851.14 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,122.02 | Professional | None | $812.83 | $954.99 | $1,122.02 |
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 $933.25 Median $1,148.15 Typical High $1,584.89 | Professional | None | $933.25 | $1,148.15 | $1,584.89 |
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 $1,148.15 Typical High $1,548.82 | Professional | None | $851.14 | $1,148.15 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,258.93 Typical High $3,090.30 | Professional | None | $758.58 | $1,258.93 | $3,090.30 |
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 $1,096.48 | Professional | None | $851.14 | $1,000.00 | $1,096.48 |
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 $1,862.09 | Professional | None | $851.14 | $1,230.27 | $1,862.09 |
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 $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $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 3.8 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· 20th of 51
$1,148
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.