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 $457.09 Median $512.86 Typical High $1,905.46 | Facility | None | $457.09 | $512.86 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | None | $512.86 | $512.86 | $575.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $4,365.16 | Facility | None | $1,230.27 | $2,041.74 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,230.27 | Facility | None | $691.83 | $1,023.29 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $1,096.48 | Professional | None | $426.58 | $575.44 | $1,096.48 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,174.90 | Facility | None | $512.86 | $512.86 | $1,174.90 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | None | $512.86 | $512.86 | $537.03 |
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 1.6 times more in Arizona than in Wyoming. 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· 23rd of 51
$525
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.