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 $933.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,819.70 | $1,995.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,479.11 | $1,479.11 | $1,513.56 |
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 $1,584.89 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,584.89 | $2,137.96 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $6,456.54 | Professional | None | $1,479.11 | $2,344.23 | $6,456.54 |
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,348.96 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,348.96 | $2,187.76 | $3,162.28 |
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 $776.25 Median $912.01 Typical High $933.25 | Professional | 52 · Reduced service | $776.25 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $154.88 | $186.21 | $186.21 |
Where Illinois sits
The same service costs 4.7 times more in Alaska than in Arkansas. 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· 38th of 51
$1,778
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.