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 $316.23 Median $1,318.26 Typical High $5,623.41 | Facility | None | $316.23 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $288.40 Typical High $338.84 | Professional | None | $89.13 | $288.40 | $338.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $208.93 Median $316.23 Typical High $1,000.00 | Facility | None | $208.93 | $316.23 | $1,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $104.71 Median $323.59 Typical High $501.19 | Professional | None | $104.71 | $323.59 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $794.33 | Facility | None | $194.98 | $281.84 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $245.47 Typical High $575.44 | Professional | None | $109.65 | $245.47 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $407.38 Typical High $1,659.59 | Professional | None | $114.82 | $407.38 | $1,659.59 |
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 $100.00 Median $112.20 Typical High $426.58 | Professional | None | $100.00 | $112.20 | $426.58 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $93.33 Median $275.42 Typical High $588.84 | Professional | None | $93.33 | $275.42 | $588.84 |
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 $45.71 Median $138.04 Typical High $169.82 | Professional | 52 · Reduced service | $45.71 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $18.20 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $208.93 Typical High $251.19 | Professional | 54 · Surgery only | $67.61 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $13.80 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $9.12 | $27.54 | $33.88 |
Where Illinois sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 32nd of 51
$269
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.