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 $75.86 Median $1,621.81 Typical High $7,762.47 | Facility | None | $75.86 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $95.50 | Professional | None | $67.61 | $75.86 | $95.50 |
BCBS Illinois Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,258.93 | Facility | None | $602.56 | $831.76 | $1,258.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $131.83 | Professional | None | $91.20 | $109.65 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $741.31 Typical High $912.01 | Facility | None | $251.19 | $741.31 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $147.91 | Professional | None | $60.26 | $102.33 | $147.91 |
Hally Health Setting Professional Modifier None Typical Low $30.20 Median $45.71 Typical High $223.87 | Professional | None | $30.20 | $45.71 | $223.87 |
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 $35.48 Median $35.48 Typical High $38.02 | Professional | None | $35.48 | $35.48 | $38.02 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $41.69 | Professional | None | $38.90 | $39.81 | $41.69 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,995.26 | Facility | None | $141.25 | $501.19 | $1,995.26 |
United Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $162.18 | Professional | None | $69.18 | $97.72 | $162.18 |
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 $33.11 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $33.11 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 54 · Surgery only | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.00 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.61 | $7.59 | $7.59 |
Where Illinois sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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
$110
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.