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 $93.33 Median $1,318.26 Typical High $5,623.41 | Facility | None | $93.33 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $151.36 | Professional | None | $51.29 | $85.11 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $724.44 | Facility | None | $95.50 | $154.88 | $724.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $58.88 Median $109.65 Typical High $173.78 | Professional | None | $58.88 | $109.65 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $120.23 Typical High $208.93 | Facility | None | $66.07 | $120.23 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $177.83 | Professional | None | $60.26 | $107.15 | $177.83 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $302.00 | Professional | None | $75.86 | $141.25 | $302.00 |
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 $64.57 Median $70.79 Typical High $134.90 | Professional | None | $64.57 | $70.79 | $134.90 |
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 $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $204.17 | Professional | None | $60.26 | $112.20 | $204.17 |
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 $25.12 Median $41.69 Typical High $46.77 | Professional | 52 · Reduced service | $25.12 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.98 Typical High $18.62 | Professional | 53 · Discontinued | $10.23 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $63.10 Typical High $70.79 | Professional | 54 · Surgery only | $38.02 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.59 Typical High $14.13 | Professional | 55 · Aftercare only | $7.59 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.13 | $8.51 | $9.33 |
Where Illinois sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 27th of 51
$112
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.