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 $60.26 Median $1,380.38 Typical High $5,623.41 | Facility | None | $60.26 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $97.72 | Professional | None | $38.02 | $57.54 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $83.18 Median $134.90 Typical High $676.08 | Facility | None | $83.18 | $134.90 | $676.08 |
BCBS Illinois Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $151.36 | Professional | None | $64.57 | $104.71 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $109.65 Typical High $741.31 | Facility | None | $74.13 | $109.65 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $489.78 | Professional | None | $138.04 | $138.04 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $181.97 | Professional | None | $77.62 | $123.03 | $181.97 |
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 $79.43 Median $81.28 Typical High $128.82 | Professional | None | $79.43 | $81.28 | $128.82 |
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 $141.25 Median $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $190.55 | Professional | None | $69.18 | $112.20 | $190.55 |
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 $19.05 Median $28.84 Typical High $44.67 | Professional | 52 · Reduced service | $19.05 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $11.48 Typical High $17.78 | Professional | 53 · Discontinued | $7.59 | $11.48 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $42.66 Typical High $67.61 | Professional | 54 · Surgery only | $28.84 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.51 Typical High $13.49 | Professional | 55 · Aftercare only | $5.75 | $8.51 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.75 Typical High $8.91 | Professional | 56 · Pre-op care only | $3.80 | $5.75 | $8.91 |
Where Illinois sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 33rd of 51
$110
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.