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 $467.74 Median $1,862.09 Typical High $5,888.44 | Facility | None | $467.74 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | None | $158.49 | $186.21 | $186.21 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $4,677.35 | Facility | None | $1,096.48 | $2,344.23 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $309.03 | Professional | None | $208.93 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $309.03 | Professional | None | $190.55 | $218.78 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $549.54 | Professional | None | $194.98 | $295.12 | $549.54 |
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 $204.17 Median $229.09 Typical High $257.04 | Professional | None | $204.17 | $229.09 | $257.04 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $245.47 | Professional | None | $33.11 | $33.11 | $245.47 |
United Setting Facility Modifier None Typical Low $138.04 Median $457.09 Typical High $1,949.84 | Facility | None | $138.04 | $457.09 | $1,949.84 |
United Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $380.19 | Professional | None | $162.18 | $213.80 | $380.19 |
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 $79.43 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $31.62 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $23.44 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.85 | $18.62 | $18.62 |
Where Illinois sits
The same service costs 4.5 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· 34th of 51
$219
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.