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 $331.13 Median $1,445.44 Typical High $5,623.41 | Facility | None | $331.13 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $131.83 | Professional | None | $53.70 | $60.26 | $131.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $1,412.54 | Facility | None | $169.82 | $208.93 | $1,412.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $117.49 | Professional | None | $64.57 | $100.00 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $104.71 | Professional | None | $52.48 | $69.18 | $104.71 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $162.18 | Professional | None | $52.48 | $79.43 | $162.18 |
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 $52.48 Median $61.66 Typical High $67.61 | Professional | None | $52.48 | $61.66 | $67.61 |
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 $141.25 Median $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $114.82 | Professional | None | $52.48 | $74.13 | $114.82 |
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 $26.30 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $26.30 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $10.47 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $44.67 Typical High $44.67 | Professional | 54 · Surgery only | $39.81 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $7.94 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.25 | $6.03 | $6.03 |
Where Illinois sits
The same service costs 6.5 times more in Tennessee 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· 18th of 51
$89.13
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.