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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | None | $512.86 | $512.86 | $562.34 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,691.53 Median $5,754.40 Typical High $11,481.54 | Facility | None | $2,691.53 | $5,754.40 | $11,481.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $891.25 | Professional | None | $562.34 | $758.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $7,079.46 | Facility | None | $602.56 | $812.83 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $933.25 | Professional | None | $199.53 | $323.59 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,905.46 | Professional | None | $478.63 | $724.44 | $1,905.46 |
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 $562.34 Median $575.44 Typical High $630.96 | Professional | None | $562.34 | $575.44 | $630.96 |
Molina Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | None | $891.25 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,288.25 | $3,981.07 | $10,471.29 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where Illinois sits
The same service costs 346.7 times more in Oklahoma than in Hawaii. 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· 43rd of 51
$813
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.