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 $47.86 Median $89.13 Typical High $4,168.69 | Facility | None | $47.86 | $89.13 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $70.79 | Professional | None | $31.62 | $44.67 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $74.13 | Professional | None | $34.67 | $54.95 | $74.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $42.66 Median $69.18 Typical High $562.34 | Facility | None | $42.66 | $69.18 | $562.34 |
BCBS Illinois Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $85.11 | Professional | None | $43.65 | $61.66 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $57.54 Typical High $512.86 | Facility | None | $39.81 | $57.54 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $81.28 | Professional | None | $41.69 | $56.23 | $81.28 |
Hally Health Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $169.82 | Professional | None | $48.98 | $74.13 | $169.82 |
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 $43.65 Median $45.71 Typical High $70.79 | Professional | None | $43.65 | $45.71 | $70.79 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $74.13 | Professional | None | $33.11 | $33.11 | $74.13 |
United Setting Facility Modifier None Typical Low $141.25 Median $512.86 Typical High $1,819.70 | Facility | None | $141.25 | $512.86 | $1,819.70 |
United Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $95.50 | Professional | None | $37.15 | $54.95 | $95.50 |
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 $17.78 Median $22.39 Typical High $26.30 | Professional | 52 · Reduced service | $17.78 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.91 Typical High $10.47 | Professional | 53 · Discontinued | $7.08 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $33.11 Typical High $38.90 | Professional | 54 · Surgery only | $26.92 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.61 Typical High $7.76 | Professional | 55 · Aftercare only | $5.37 | $6.61 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.47 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.55 | $4.47 | $5.25 |
Where Illinois sits
The same service costs 4.2 times more in Alaska than in New York. 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
$57.54
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.