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 $933.25 Median $4,897.79 Typical High $16,982.44 | Facility | None | $933.25 | $4,897.79 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $9,549.93 | Professional | None | $912.01 | $912.01 | $9,549.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 52 · Reduced service | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $114.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $19,054.61 Median $23,988.33 Typical High $30,199.52 | Facility | None | $19,054.61 | $23,988.33 | $30,199.52 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $23,442.29 Typical High $28,840.32 | Facility | None | $7,413.10 | $23,442.29 | $28,840.32 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $346.74 | Professional | None | $100.00 | $125.89 | $346.74 |
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 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $9,549.93 Typical High $28,840.32 | Facility | None | $1,659.59 | $9,549.93 | $28,840.32 |
1 more rate 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 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $691.83 | $851.14 |
Where Illinois sits
The same service costs 5754.4 times more in Oklahoma than in Maine. 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· 28th of 51
$10,233
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.