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 $275.42 Median $1,318.26 Typical High $5,623.41 | Facility | None | $275.42 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $323.59 | Professional | None | $74.13 | $213.80 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS Illinois Setting Facility Modifier None Typical Low $501.19 Median $1,071.52 Typical High $2,137.96 | Facility | None | $501.19 | $1,071.52 | $2,137.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $89.13 Median $288.40 Typical High $616.60 | Professional | None | $89.13 | $288.40 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $549.54 | Professional | None | $87.10 | $208.93 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $416.87 Typical High $1,000.00 | Professional | None | $112.20 | $416.87 | $1,000.00 |
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 $95.50 Median $102.33 Typical High $398.11 | Professional | None | $95.50 | $102.33 | $398.11 |
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 $173.78 Median $1,000.00 Typical High $3,235.94 | Facility | None | $173.78 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $89.13 Median $245.47 Typical High $524.81 | Professional | None | $89.13 | $245.47 | $524.81 |
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 $38.02 Median $114.82 Typical High $151.36 | Professional | 52 · Reduced service | $38.02 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $45.71 Typical High $61.66 | Professional | 53 · Discontinued | $15.14 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $173.78 Typical High $229.09 | Professional | 54 · Surgery only | $58.88 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $34.67 Typical High $45.71 | Professional | 55 · Aftercare only | $11.48 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $7.59 | $22.91 | $30.90 |
Where Illinois sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 29th of 51
$240
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.