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 $380.19 Median $1,445.44 Typical High $5,623.41 | Facility | None | $380.19 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $389.05 | Professional | None | $245.47 | $257.04 | $389.05 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $5,011.87 | Facility | None | $2,238.72 | $3,090.30 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,570.40 Typical High $3,311.31 | Facility | None | $489.78 | $2,570.40 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $426.58 | Professional | None | $234.42 | $263.03 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $851.14 | Professional | None | $165.96 | $234.42 | $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 $181.97 Median $194.98 Typical High $208.93 | Professional | None | $181.97 | $194.98 | $208.93 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | None | $95.50 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $467.74 | Professional | None | $251.19 | $288.40 | $467.74 |
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 $120.23 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $48.98 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $36.31 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $25.70 |
Where Illinois sits
The same service costs 4.6 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· 42nd of 51
$263
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.