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 $512.86 Median $2,137.96 Typical High $7,762.47 | Facility | None | $512.86 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $489.78 | Professional | None | $151.36 | $169.82 | $489.78 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,570.40 Median $5,754.40 Typical High $8,128.31 | Facility | None | $2,570.40 | $5,754.40 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,623.41 Typical High $7,244.36 | Facility | None | $741.31 | $5,623.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $288.40 | Professional | None | $151.36 | $194.98 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $537.03 | Professional | None | $144.54 | $213.80 | $537.03 |
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 $147.91 Median $173.78 Typical High $194.98 | Professional | None | $147.91 | $173.78 | $194.98 |
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 $1,479.11 Median $5,011.87 Typical High $13,489.63 | Facility | None | $1,479.11 | $5,011.87 | $13,489.63 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $323.59 | Professional | None | $147.91 | $223.87 | $323.59 |
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 $74.13 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 54 · Surgery only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $16.98 |
Where Illinois sits
The same service costs 17.8 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· 29th of 51
$275
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.