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 $66.07 Median $1,318.26 Typical High $5,623.41 | Facility | None | $66.07 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $58.88 Typical High $83.18 | Professional | None | $27.54 | $58.88 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
BCBS Illinois Setting Facility Modifier None Typical Low $158.49 Median $338.84 Typical High $676.08 | Facility | None | $158.49 | $338.84 | $676.08 |
BCBS Illinois Setting Professional Modifier None Typical Low $30.90 Median $70.79 Typical High $120.23 | Professional | None | $30.90 | $70.79 | $120.23 |
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 $32.36 Median $70.79 Typical High $114.82 | Professional | None | $32.36 | $70.79 | $114.82 |
Hally Health Setting Professional Modifier None Typical Low $38.90 Median $93.33 Typical High $194.98 | Professional | None | $38.90 | $93.33 | $194.98 |
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 $36.31 Median $38.02 Typical High $93.33 | Professional | None | $36.31 | $38.02 | $93.33 |
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 $33.11 Median $64.57 Typical High $125.89 | Professional | None | $33.11 | $64.57 | $125.89 |
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 $13.18 Median $26.30 Typical High $32.36 | Professional | 52 · Reduced service | $13.18 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $10.47 Typical High $13.18 | Professional | 53 · Discontinued | $5.25 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $38.90 Typical High $48.98 | Professional | 54 · Surgery only | $19.50 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $7.94 Typical High $9.77 | Professional | 55 · Aftercare only | $3.98 | $7.94 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $5.25 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.63 | $5.25 | $6.61 |
Where Illinois sits
The same service costs 3.3 times more in Alaska 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· 34th of 51
$66.07
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.