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 $1,445.44 Typical High $5,623.41 | Facility | None | $346.74 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $154.88 | Professional | None | $102.33 | $123.03 | $154.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $1,584.89 | Facility | None | $588.84 | $870.96 | $1,584.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $346.74 | Professional | None | $181.97 | $199.53 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $912.01 | Facility | None | $467.74 | $724.44 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $245.47 | Professional | None | $114.82 | $169.82 | $245.47 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $457.09 | Professional | None | $125.89 | $186.21 | $457.09 |
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 $125.89 Median $151.36 Typical High $173.78 | Professional | None | $125.89 | $151.36 | $173.78 |
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 $446.68 Median $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $263.03 | Professional | None | $112.20 | $169.82 | $263.03 |
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 $51.29 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $20.42 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | 54 · Surgery only | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $12.30 |
Where Illinois sits
The same service costs 4.4 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
$200
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.