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 $218.78 Median $1,380.38 Typical High $5,623.41 | Facility | None | $218.78 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $194.98 Typical High $218.78 | Professional | None | $67.61 | $194.98 | $218.78 |
BCBS Illinois Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $1,584.89 | Facility | None | $371.54 | $794.33 | $1,584.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $398.11 | Professional | None | $85.11 | $208.93 | $398.11 |
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 $87.10 Median $218.78 Typical High $407.38 | Professional | None | $87.10 | $218.78 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $309.03 Typical High $537.03 | Professional | None | $100.00 | $309.03 | $537.03 |
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 $83.18 Median $93.33 Typical High $309.03 | Professional | None | $83.18 | $93.33 | $309.03 |
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 $85.11 Median $229.09 Typical High $501.19 | Professional | None | $85.11 | $229.09 | $501.19 |
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 $33.11 Median $54.95 Typical High $109.65 | Professional | 52 · Reduced service | $33.11 | $54.95 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.88 Typical High $43.65 | Professional | 53 · Discontinued | $13.49 | $21.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $83.18 Typical High $162.18 | Professional | 54 · Surgery only | $50.12 | $83.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.60 Typical High $32.36 | Professional | 55 · Aftercare only | $10.00 | $16.60 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.96 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.76 | $10.96 | $21.88 |
Where Illinois sits
The same service costs 4.5 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· 43rd of 51
$219
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.