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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $426.58 Typical High $1,071.52 | Professional | None | $416.87 | $426.58 | $1,071.52 |
BCBS Illinois Setting Facility Modifier None Typical Low $11,748.98 Median $13,803.84 Typical High $17,378.01 | Facility | None | $11,748.98 | $13,803.84 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $13,803.84 Typical High $17,378.01 | Facility | None | $776.25 | $13,803.84 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $831.76 | Professional | None | $457.09 | $676.08 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $812.83 | Professional | None | $371.54 | $602.56 | $812.83 |
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 $457.09 Median $489.78 Typical High $537.03 | Professional | None | $457.09 | $489.78 | $537.03 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,398.83 | $7,585.78 |
United Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $870.96 | Professional | None | $398.11 | $549.54 | $870.96 |
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 $208.93 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $47.86 |
Where Illinois sits
The same service costs 5.9 times more in Arkansas 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
$692
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.