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 $512.86 Median $1,621.81 Typical High $7,762.47 | Facility | None | $512.86 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $524.81 | Professional | None | $407.38 | $512.86 | $524.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,090.30 Median $6,606.93 Typical High $13,182.57 | Facility | None | $3,090.30 | $6,606.93 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $933.25 | Professional | None | $537.03 | $691.83 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $1,548.82 | Professional | None | $457.09 | $776.25 | $1,548.82 |
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 $501.19 Median $630.96 Typical High $724.44 | Professional | None | $501.19 | $630.96 | $724.44 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,096.48 | Professional | None | $446.68 | $645.65 | $1,096.48 |
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 $204.17 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $51.29 |
Where Illinois sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$676
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.