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 $346.74 Median $1,621.81 Typical High $7,762.47 | Facility | None | $346.74 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $257.04 | Professional | None | $125.89 | $147.91 | $257.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $7,079.46 | Facility | None | $758.58 | $1,148.15 | $7,079.46 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $1,513.56 | Facility | None | $489.78 | $933.25 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $251.19 | Professional | None | $147.91 | $173.78 | $251.19 |
Hally Health Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $1,513.56 | Professional | None | $158.49 | $251.19 | $1,513.56 |
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 $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,235.94 | Facility | None | $446.68 | $1,047.13 | $3,235.94 |
United Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $309.03 | Professional | None | $131.83 | $173.78 | $309.03 |
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 $63.10 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $109.65 Typical High $123.03 | Professional | 54 · Surgery only | $95.50 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $24.55 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $16.22 |
Where Illinois sits
The same service costs 4.3 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· 22nd of 51
$263
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.