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 $107.15 Median $117.49 Typical High $3,235.94 | Professional | None | $107.15 | $117.49 | $3,235.94 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $2,754.23 | Facility | None | $1,258.93 | $2,238.72 | $2,754.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $154.88 | Professional | None | $123.03 | $123.03 | $154.88 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $616.60 | Professional | None | $125.89 | $194.98 | $616.60 |
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 $151.36 Typical High $162.18 | Professional | None | $147.91 | $151.36 | $162.18 |
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 $1,318.26 Median $2,570.40 Typical High $4,677.35 | Facility | None | $1,318.26 | $2,570.40 | $4,677.35 |
United Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $275.42 | Professional | None | $97.72 | $162.18 | $275.42 |
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 $53.70 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $53.70 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $21.38 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $81.28 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $14.13 |
Where Illinois sits
The same service costs 37.2 times more in Oklahoma 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
$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.