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 $173.78 Median $194.98 Typical High $295.12 | Professional | None | $173.78 | $194.98 | $295.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $4,466.84 Typical High $6,309.57 | Facility | None | $2,511.89 | $4,466.84 | $6,309.57 |
BCBS Illinois Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $323.59 | Professional | None | $204.17 | $257.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,365.16 Typical High $5,495.41 | Facility | None | $1,548.82 | $4,365.16 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $380.19 | Professional | None | $199.53 | $251.19 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $851.14 | Professional | None | $190.55 | $302.00 | $851.14 |
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 $218.78 Median $234.42 Typical High $257.04 | Professional | None | $218.78 | $234.42 | $257.04 |
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 $1,288.25 Median $4,073.80 Typical High $10,715.19 | Facility | None | $1,288.25 | $4,073.80 | $10,715.19 |
United Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $436.52 | Professional | None | $173.78 | $269.15 | $436.52 |
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 $87.10 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $34.67 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $17.38 | $19.50 | $19.50 |
Where Illinois sits
The same service costs 10.2 times more in Oklahoma than in Kentucky. 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· 27th of 51
$288
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.