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 $52.48 Median $104.71 Typical High $4,677.35 | Facility | None | $52.48 | $104.71 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $87.10 | Professional | None | $43.65 | $54.95 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | None | $63.10 | $63.10 | $67.61 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $1,096.48 | Facility | None | $257.04 | $549.54 | $1,096.48 |
BCBS Illinois Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $107.15 | Professional | None | $53.70 | $74.13 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $112.20 | Professional | None | $54.95 | $75.86 | $112.20 |
Hally Health Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $199.53 | Professional | None | $57.54 | $87.10 | $199.53 |
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 $58.88 Median $63.10 Typical High $81.28 | Professional | None | $58.88 | $63.10 | $81.28 |
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 $138.04 Median $457.09 Typical High $1,949.84 | Facility | None | $138.04 | $457.09 | $1,949.84 |
United Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $120.23 | Professional | None | $50.12 | $74.13 | $120.23 |
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 $21.38 Median $24.55 Typical High $27.54 | Professional | 52 · Reduced service | $21.38 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.00 Typical High $10.96 | Professional | 53 · Discontinued | $8.51 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $36.31 Typical High $41.69 | Professional | 54 · Surgery only | $31.62 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.41 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $7.41 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.01 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.27 | $5.01 | $5.50 |
Where Illinois sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 25th of 51
$74.13
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.