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 $89.13 Median $1,318.26 Typical High $5,623.41 | Facility | None | $89.13 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $125.89 | Professional | None | $61.66 | $81.28 | $125.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $83.18 Median $134.90 Typical High $870.96 | Facility | None | $83.18 | $134.90 | $870.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $186.21 | Professional | None | $75.86 | $114.82 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $501.19 | Facility | None | $66.07 | $107.15 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $144.54 | Professional | None | $72.44 | $93.33 | $144.54 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $309.03 | Professional | None | $85.11 | $125.89 | $309.03 |
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 $77.62 Median $83.18 Typical High $120.23 | Professional | None | $77.62 | $83.18 | $120.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $138.04 | Professional | None | $33.11 | $33.11 | $138.04 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $154.88 | Professional | None | $64.57 | $87.10 | $154.88 |
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 $31.62 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $31.62 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $12.59 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $54.95 Typical High $66.07 | Professional | 54 · Surgery only | $47.86 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $9.55 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $8.91 |
Where Illinois sits
The same service costs 3.8 times more in Alaska 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· 32nd of 51
$93.33
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.