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 $36.31 Median $123.03 Typical High $5,623.41 | Facility | None | $36.31 | $123.03 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $134.90 | Professional | None | $28.84 | $60.26 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $169.82 | Professional | None | $69.18 | $89.13 | $169.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $724.44 | Facility | None | $323.59 | $588.84 | $724.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $162.18 | Professional | None | $33.88 | $87.10 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $63.10 Typical High $154.88 | Professional | None | $32.36 | $63.10 | $154.88 |
Hally Health Setting Professional Modifier None Typical Low $38.90 Median $117.49 Typical High $199.53 | Professional | None | $38.90 | $117.49 | $199.53 |
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 $39.81 Median $41.69 Typical High $128.82 | Professional | None | $39.81 | $41.69 | $128.82 |
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 $31.62 Median $69.18 Typical High $173.78 | Professional | None | $31.62 | $69.18 | $173.78 |
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 $14.45 Median $37.15 Typical High $45.71 | Professional | 52 · Reduced service | $14.45 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $14.79 Typical High $18.62 | Professional | 53 · Discontinued | $5.75 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $56.23 Typical High $69.18 | Professional | 54 · Surgery only | $21.38 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $11.22 Typical High $13.80 | Professional | 55 · Aftercare only | $4.37 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $7.41 Typical High $9.12 | Professional | 56 · Pre-op care only | $2.88 | $7.41 | $9.12 |
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· 26th of 51
$81.28
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.