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 $269.15 Median $1,380.38 Typical High $5,623.41 | Facility | None | $269.15 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $239.88 Typical High $269.15 | Professional | None | $79.43 | $239.88 | $269.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $1,230.27 | Facility | None | $416.87 | $616.60 | $1,230.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $575.44 | Professional | None | $104.71 | $257.04 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $794.33 | Facility | None | $398.11 | $549.54 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $275.42 Typical High $549.54 | Professional | None | $107.15 | $275.42 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $398.11 Typical High $724.44 | Professional | None | $123.03 | $398.11 | $724.44 |
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 $104.71 Median $112.20 Typical High $398.11 | Professional | None | $104.71 | $112.20 | $398.11 |
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 $446.68 Median $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $97.72 Median $245.47 Typical High $537.03 | Professional | None | $97.72 | $245.47 | $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 $39.81 Median $67.61 Typical High $134.90 | Professional | 52 · Reduced service | $39.81 | $67.61 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $27.54 Typical High $53.70 | Professional | 53 · Discontinued | $15.85 | $27.54 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $102.33 Typical High $199.53 | Professional | 54 · Surgery only | $60.26 | $102.33 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $20.42 Typical High $40.74 | Professional | 55 · Aftercare only | $12.02 | $20.42 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $7.94 | $21.88 | $26.92 |
Where Illinois sits
The same service costs 4.3 times more in Oklahoma than in Nebraska. 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
$302
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.