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 $45.71 Median $1,202.26 Typical High $7,762.47 | Facility | None | $45.71 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $165.96 | Professional | None | $45.71 | $91.20 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $223.87 | Professional | None | $93.33 | $109.65 | $223.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $891.25 | Facility | None | $257.04 | $302.00 | $891.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $50.12 Median $117.49 Typical High $199.53 | Professional | None | $50.12 | $117.49 | $199.53 |
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 $51.29 Median $87.10 Typical High $190.55 | Professional | None | $51.29 | $87.10 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $144.54 Typical High $245.47 | Professional | None | $63.10 | $144.54 | $245.47 |
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 $57.54 Median $60.26 Typical High $158.49 | Professional | None | $57.54 | $60.26 | $158.49 |
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 $52.48 Median $97.72 Typical High $213.80 | Professional | None | $52.48 | $97.72 | $213.80 |
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 $20.89 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $20.89 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $18.20 Typical High $22.39 | Professional | 53 · Discontinued | $8.32 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $67.61 Typical High $83.18 | Professional | 54 · Surgery only | $31.62 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $13.49 Typical High $16.98 | Professional | 55 · Aftercare only | $6.31 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $9.12 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.17 | $9.12 | $11.22 |
Where Illinois sits
The same service costs 3.4 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· 22nd of 51
$107
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.