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 $30.20 Median $1,318.26 Typical High $5,623.41 | Facility | None | $30.20 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $28.84 Typical High $50.12 | Professional | None | $21.38 | $28.84 | $50.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $562.34 | Facility | None | $131.83 | $281.84 | $562.34 |
BCBS Illinois Setting Professional Modifier None Typical Low $28.18 Median $40.74 Typical High $60.26 | Professional | None | $28.18 | $40.74 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $776.25 Typical High $2,511.89 | Facility | None | $446.68 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $58.88 | Professional | None | $28.84 | $40.74 | $58.88 |
Hally Health Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $123.03 | Professional | None | $30.20 | $46.77 | $123.03 |
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 $28.84 Median $31.62 Typical High $44.67 | Professional | None | $28.84 | $31.62 | $44.67 |
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 $25.70 Median $40.74 Typical High $64.57 | Professional | None | $25.70 | $40.74 | $64.57 |
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 $10.72 Median $13.49 Typical High $15.14 | Professional | 52 · Reduced service | $10.72 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.37 Typical High $6.03 | Professional | 53 · Discontinued | $4.27 | $5.37 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $20.42 Typical High $22.91 | Professional | 54 · Surgery only | $16.22 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.07 Typical High $4.57 | Professional | 55 · Aftercare only | $3.24 | $4.07 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.69 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.14 | $2.69 | $3.02 |
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· 20th of 51
$40.74
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.