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 $57.54 Typical High $57.54 | Professional | None | $53.70 | $57.54 | $57.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $371.54 Median $549.54 Typical High $831.76 | Facility | None | $371.54 | $549.54 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Facility | None | $346.74 | $467.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $81.28 | Professional | None | $51.29 | $61.66 | $81.28 |
Hally Health Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $251.19 | Professional | None | $51.29 | $74.13 | $251.19 |
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 $58.88 Median $61.66 Typical High $64.57 | Professional | None | $58.88 | $61.66 | $64.57 |
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 $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $102.33 | Professional | None | $52.48 | $64.57 | $102.33 |
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 $26.92 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $26.92 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $10.72 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 54 · Surgery only | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.13 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.37 | $5.75 | $5.75 |
Where Illinois sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 34th of 51
$61.66
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.