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 $1,621.81 Typical High $7,762.47 | Facility | None | $380.19 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | None | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $38.02 |
BCBS Illinois Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | None | $524.81 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $616.60 | Professional | None | $389.05 | $512.86 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $3,981.07 | Professional | None | $549.54 | $812.83 | $3,981.07 |
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 $645.65 Median $676.08 Typical High $741.31 | Professional | None | $645.65 | $676.08 | $741.31 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $851.14 | Professional | None | $524.81 | $707.95 | $851.14 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $933.25 | Professional | None | $338.84 | $537.03 | $933.25 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $47.86 | $47.86 |
Where Illinois sits
The same service costs 15.1 times more in New York than in Hawaii. 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· 23rd of 51
$513
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.