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 $162.18 Median $1,202.26 Typical High $7,762.47 | Facility | None | $162.18 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $275.42 | Professional | None | $151.36 | $239.88 | $275.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $251.19 Median $467.74 Typical High $2,041.74 | Facility | None | $251.19 | $467.74 | $2,041.74 |
BCBS Illinois Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $616.60 | Professional | None | $194.98 | $338.84 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $288.40 Typical High $407.38 | Facility | None | $158.49 | $288.40 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $467.74 | Professional | None | $169.82 | $229.09 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $912.01 | Professional | None | $204.17 | $380.19 | $912.01 |
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 $190.55 Median $204.17 Typical High $389.05 | Professional | None | $190.55 | $204.17 | $389.05 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $457.09 | Professional | None | $33.11 | $33.11 | $457.09 |
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 $147.91 Median $239.88 Typical High $457.09 | Professional | None | $147.91 | $239.88 | $457.09 |
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 $77.62 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $77.62 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $30.90 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $114.82 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $34.67 Typical High $40.74 | Professional | 55 · Aftercare only | $22.91 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $27.54 |
Where Illinois sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 37th of 51
$245
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.