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 $933.25 Median $4,677.35 Typical High $9,772.37 | Facility | None | $933.25 | $4,677.35 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $7,079.46 | Professional | None | $4,168.69 | $4,897.79 | $7,079.46 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,570.40 Median $3,548.13 Typical High $5,248.07 | Facility | None | $2,570.40 | $3,548.13 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,019.95 Typical High $3,890.45 | Facility | None | $776.25 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $7,762.47 | Professional | None | $3,981.07 | $6,025.60 | $7,762.47 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $6,165.95 | Professional | None | $100.00 | $151.36 | $6,165.95 |
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 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,445.44 Typical High $8,317.64 | Facility | None | $489.78 | $1,445.44 | $8,317.64 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $8,709.64 | Professional | None | $4,073.80 | $5,623.41 | $8,709.64 |
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 $2,089.30 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,089.30 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $831.76 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,162.28 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $416.87 | $489.78 | $489.78 |
Where Illinois sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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
$4,898
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.