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 $1,288.25 Typical High $5,623.41 | Facility | None | $52.48 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $45.71 Typical High $85.11 | Professional | None | $24.55 | $45.71 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $588.84 | Facility | None | $57.54 | $93.33 | $588.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $30.20 Median $58.88 Typical High $100.00 | Professional | None | $30.20 | $58.88 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $72.44 Typical High $125.89 | Facility | None | $50.12 | $72.44 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $97.72 | Professional | None | $30.90 | $53.70 | $97.72 |
Hally Health Setting Professional Modifier None Typical Low $34.67 Median $75.86 Typical High $131.83 | Professional | None | $34.67 | $75.86 | $131.83 |
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 $32.36 Median $33.88 Typical High $77.62 | Professional | None | $32.36 | $33.88 | $77.62 |
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 $30.20 Median $53.70 Typical High $100.00 | Professional | None | $30.20 | $53.70 | $100.00 |
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 $11.75 Median $21.38 Typical High $26.30 | Professional | 52 · Reduced service | $11.75 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $8.51 Typical High $10.47 | Professional | 53 · Discontinued | $4.68 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $31.62 Typical High $38.90 | Professional | 54 · Surgery only | $17.38 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $3.47 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $4.27 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.34 | $4.27 | $5.25 |
Where Illinois sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 26th of 51
$54.95
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.