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 $162.18 Median $1,318.26 Typical High $5,623.41 | Facility | None | $162.18 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $208.93 | Professional | None | $63.10 | $151.36 | $208.93 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $630.96 | Facility | None | $257.04 | $346.74 | $630.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $53.70 Median $131.83 Typical High $229.09 | Professional | None | $53.70 | $131.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $616.60 | Facility | None | $257.04 | $389.05 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $234.42 | Professional | None | $60.26 | $147.91 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $181.97 Typical High $363.08 | Professional | None | $69.18 | $181.97 | $363.08 |
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 $70.79 Median $70.79 Typical High $194.98 | Professional | None | $70.79 | $70.79 | $194.98 |
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 $478.63 Median $478.63 Typical High $537.03 | Facility | None | $478.63 | $478.63 | $537.03 |
United Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $316.23 | Professional | None | $69.18 | $154.88 | $316.23 |
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 $34.67 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $34.67 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $13.80 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $109.65 Typical High $131.83 | Professional | 54 · Surgery only | $52.48 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $21.88 Typical High $26.30 | Professional | 55 · Aftercare only | $10.47 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $13.80 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $13.80 | $17.78 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$162
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.