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 $56.23 Median $1,318.26 Typical High $5,623.41 | Facility | None | $56.23 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $50.12 Typical High $61.66 | Professional | None | $25.12 | $50.12 | $61.66 |
BCBS Illinois Setting Facility Modifier None Typical Low $154.88 Median $331.13 Typical High $676.08 | Facility | None | $154.88 | $331.13 | $676.08 |
BCBS Illinois Setting Professional Modifier None Typical Low $31.62 Median $66.07 Typical High $112.20 | Professional | None | $31.62 | $66.07 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $2,691.53 | Facility | None | $50.12 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $109.65 | Professional | None | $32.36 | $46.77 | $109.65 |
Hally Health Setting Professional Modifier None Typical Low $36.31 Median $77.62 Typical High $186.21 | Professional | None | $36.31 | $77.62 | $186.21 |
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 $33.11 Median $36.31 Typical High $81.28 | Professional | None | $33.11 | $36.31 | $81.28 |
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 $30.90 Median $57.54 Typical High $107.15 | Professional | None | $30.90 | $57.54 | $107.15 |
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 $12.59 Median $22.39 Typical High $28.18 | Professional | 52 · Reduced service | $12.59 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $8.91 Typical High $11.22 | Professional | 53 · Discontinued | $5.01 | $8.91 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $33.11 Typical High $42.66 | Professional | 54 · Surgery only | $19.05 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.76 Typical High $8.51 | Professional | 55 · Aftercare only | $3.80 | $6.76 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.47 Typical High $5.62 | Professional | 56 · Pre-op care only | $2.51 | $4.47 | $5.62 |
Where Illinois sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 30th of 51
$56.23
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.