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 $562.34 Median $1,445.44 Typical High $5,623.41 | Facility | None | $562.34 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $812.83 | Professional | None | $562.34 | $562.34 | $812.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $9,772.37 Typical High $14,791.08 | Facility | None | $7,413.10 | $9,772.37 | $14,791.08 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $8,912.51 Typical High $11,220.18 | Facility | None | $776.25 | $8,912.51 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $1,023.29 | Professional | None | $602.56 | $630.96 | $1,023.29 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $2,754.23 | Professional | None | $562.34 | $891.25 | $2,754.23 |
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 $660.69 Median $707.95 Typical High $758.58 | Professional | None | $660.69 | $707.95 | $758.58 |
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 $676.08 Median $1,513.56 Typical High $4,677.35 | Facility | None | $676.08 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,258.93 | Professional | None | $588.84 | $794.33 | $1,258.93 |
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 $281.84 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $64.57 |
Where Illinois sits
The same service costs 3.9 times more in Alaska 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· 28th of 51
$813
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.