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 $5.37 Median $1,318.26 Typical High $5,623.41 | Facility | None | $5.37 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $5.50 Typical High $9.77 | Professional | None | $1.78 | $5.50 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $5.89 Typical High $7.59 | Professional | None | $2.04 | $5.89 | $7.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $7.76 Median $16.60 Typical High $33.11 | Facility | None | $7.76 | $16.60 | $33.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $1.91 Median $5.62 Typical High $10.47 | Professional | None | $1.91 | $5.62 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $2,691.53 | Facility | None | $50.12 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2.09 Median $7.41 Typical High $11.48 | Professional | None | $2.09 | $7.41 | $11.48 |
Hally Health Setting Professional Modifier None Typical Low $2.45 Median $8.71 Typical High $19.05 | Professional | None | $2.45 | $8.71 | $19.05 |
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 $2.45 Median $2.45 Typical High $8.51 | Professional | None | $2.45 | $2.45 | $8.51 |
Molina Setting Professional Modifier None Typical Low $1.86 Median $1.91 Typical High $8.91 | Professional | None | $1.86 | $1.91 | $8.91 |
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 $2.40 Median $6.03 Typical High $11.22 | Professional | None | $2.40 | $6.03 | $11.22 |
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 $0.87 Median $2.45 Typical High $2.95 | Professional | 52 · Reduced service | $0.87 | $2.45 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.98 Typical High $1.17 | Professional | 53 · Discontinued | $0.35 | $0.98 | $1.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.32 Median $3.63 Typical High $4.47 | Professional | 54 · Surgery only | $1.32 | $3.63 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.72 Typical High $0.89 | Professional | 55 · Aftercare only | $0.26 | $0.72 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.49 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.18 | $0.49 | $0.59 |
Where Illinois sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 27th of 51
$6.46
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.