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 $57.54 Median $1,202.26 Typical High $7,762.47 | Facility | None | $57.54 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $109.65 | Professional | None | $52.48 | $77.62 | $109.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $758.58 | Facility | None | $77.62 | $125.89 | $758.58 |
BCBS Illinois Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $177.83 | Professional | None | $69.18 | $109.65 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $512.86 | Facility | None | $72.44 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $151.36 | Professional | None | $66.07 | $89.13 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $251.19 | Professional | None | $75.86 | $125.89 | $251.19 |
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 $66.07 Median $72.44 Typical High $125.89 | Professional | None | $66.07 | $72.44 | $125.89 |
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 $141.25 Median $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $177.83 | Professional | None | $64.57 | $100.00 | $177.83 |
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 $26.92 Median $38.90 Typical High $44.67 | Professional | 52 · Reduced service | $26.92 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $10.72 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $58.88 Typical High $67.61 | Professional | 54 · Surgery only | $40.74 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $8.13 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.76 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.37 | $7.76 | $8.91 |
Where Illinois sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 33rd of 51
$97.72
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.