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 $70.79 Median $1,202.26 Typical High $7,762.47 | Facility | None | $70.79 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $100.00 | Professional | None | $64.57 | $83.18 | $100.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $870.96 | Facility | None | $120.23 | $234.42 | $870.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $223.87 | Professional | None | $85.11 | $138.04 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $147.91 Typical High $251.19 | Facility | None | $81.28 | $147.91 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $173.78 | Professional | None | $66.07 | $89.13 | $173.78 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $338.84 | Professional | None | $83.18 | $138.04 | $338.84 |
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 $83.18 Median $89.13 Typical High $141.25 | Professional | None | $83.18 | $89.13 | $141.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $165.96 | Professional | None | $33.11 | $33.11 | $165.96 |
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 $91.20 Typical High $169.82 | Professional | None | $64.57 | $91.20 | $169.82 |
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 $32.36 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $32.36 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $12.88 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $63.10 Typical High $74.13 | Professional | 54 · Surgery only | $50.12 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $10.00 |
Where Illinois sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$100
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.