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 $346.74 Median $1,548.82 Typical High $5,623.41 | Facility | None | $346.74 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $263.03 | Professional | None | $125.89 | $134.90 | $263.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,041.74 Median $3,890.45 Typical High $4,786.30 | Facility | None | $2,041.74 | $3,890.45 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $3,630.78 Typical High $4,570.88 | Facility | None | $478.63 | $3,630.78 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $223.87 | Professional | None | $123.03 | $141.25 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $478.63 | Professional | None | $123.03 | $181.97 | $478.63 |
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 $141.25 Median $144.54 Typical High $154.88 | Professional | None | $141.25 | $144.54 | $154.88 |
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 $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $263.03 | Professional | None | $120.23 | $186.21 | $263.03 |
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 $63.10 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $63.10 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $25.12 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $14.13 |
Where Illinois sits
The same service costs 12.9 times more in Arkansas 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· 30th of 51
$219
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.