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 $29.51 Median $75.86 Typical High $4,677.35 | Facility | None | $29.51 | $75.86 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $39.81 Typical High $69.18 | Professional | None | $22.91 | $39.81 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $64.57 | Professional | None | $46.77 | $50.12 | $64.57 |
BCBS Illinois Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $426.58 | Facility | None | $75.86 | $91.20 | $426.58 |
BCBS Illinois Setting Professional Modifier None Typical Low $26.92 Median $48.98 Typical High $77.62 | Professional | None | $26.92 | $48.98 | $77.62 |
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 $26.92 Median $41.69 Typical High $75.86 | Professional | None | $26.92 | $41.69 | $75.86 |
Hally Health Setting Professional Modifier None Typical Low $30.90 Median $58.88 Typical High $91.20 | Professional | None | $30.90 | $58.88 | $91.20 |
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 $28.18 Median $30.20 Typical High $58.88 | Professional | None | $28.18 | $30.20 | $58.88 |
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 $1,819.70 | Facility | None | $138.04 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $25.12 Median $44.67 Typical High $79.43 | Professional | None | $25.12 | $44.67 | $79.43 |
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 $11.48 Median $16.98 Typical High $21.88 | Professional | 52 · Reduced service | $11.48 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $6.76 Typical High $8.71 | Professional | 53 · Discontinued | $4.57 | $6.76 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $25.70 Typical High $32.36 | Professional | 54 · Surgery only | $17.38 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $5.13 Typical High $6.46 | Professional | 55 · Aftercare only | $3.47 | $5.13 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.39 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.29 | $3.39 | $4.37 |
Where Illinois sits
The same service costs 3.5 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· 29th of 51
$44.67
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.