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 $25.70 Median $537.03 Typical High $5,128.61 | Facility | None | $25.70 | $537.03 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $51.29 Typical High $112.20 | Professional | None | $19.95 | $51.29 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $100.00 | Professional | None | $67.61 | $100.00 | $100.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $208.93 Median $288.40 Typical High $407.38 | Facility | None | $208.93 | $288.40 | $407.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $23.99 Median $72.44 Typical High $134.90 | Professional | None | $23.99 | $72.44 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $251.19 Typical High $812.83 | Facility | None | $50.12 | $251.19 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $50.12 Typical High $125.89 | Professional | None | $24.55 | $50.12 | $125.89 |
Hally Health Setting Professional Modifier None Typical Low $28.84 Median $93.33 Typical High $147.91 | Professional | None | $28.84 | $93.33 | $147.91 |
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 $26.30 Median $28.18 Typical High $107.15 | Professional | None | $26.30 | $28.18 | $107.15 |
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 $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $23.44 Median $52.48 Typical High $128.82 | Professional | None | $23.44 | $52.48 | $128.82 |
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 $9.33 Median $26.30 Typical High $37.15 | Professional | 52 · Reduced service | $9.33 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $11.48 Typical High $14.79 | Professional | 53 · Discontinued | $3.80 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $39.81 Typical High $56.23 | Professional | 54 · Surgery only | $14.13 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $8.71 Typical High $11.22 | Professional | 55 · Aftercare only | $2.82 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $5.75 Typical High $7.41 | Professional | 56 · Pre-op care only | $1.91 | $5.75 | $7.41 |
Where Illinois sits
The same service costs 3.4 times more in Wisconsin 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· 29th of 51
$64.57
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.