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 $251.19 Median $263.03 Typical High $263.03 | Professional | None | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $26.30 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,090.30 Median $7,943.28 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,943.28 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $8,511.38 Typical High $10,715.19 | Facility | None | $776.25 | $8,511.38 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | None | $275.42 | $331.13 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $1,380.38 | Professional | None | $269.15 | $389.05 | $1,380.38 |
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 $302.00 Median $323.59 Typical High $354.81 | Professional | None | $302.00 | $323.59 | $354.81 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $512.86 | Professional | None | $275.42 | $316.23 | $512.86 |
1 more rate 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 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $190.55 | $194.98 | $194.98 |
Where Illinois sits
The same service costs 4.3 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· 30th of 51
$324
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.