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 $245.47 Median $1,318.26 Typical High $5,623.41 | Facility | None | $245.47 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $245.47 | Professional | None | $154.88 | $223.87 | $245.47 |
BCBS Illinois Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $1,995.26 | Facility | None | $251.19 | $436.52 | $1,995.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $549.54 | Professional | None | $190.55 | $309.03 | $549.54 |
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 $165.96 Median $223.87 Typical High $426.58 | Professional | None | $165.96 | $223.87 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $794.33 | Professional | None | $199.53 | $338.84 | $794.33 |
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 $186.21 Median $204.17 Typical High $354.81 | Professional | None | $186.21 | $204.17 | $354.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $407.38 | Professional | None | $33.11 | $33.11 | $407.38 |
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 $154.88 Median $234.42 Typical High $416.87 | Professional | None | $154.88 | $234.42 | $416.87 |
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 $75.86 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $30.20 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $20.89 | $24.55 |
Where Illinois sits
The same service costs 3.9 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· 31st 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.