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 $309.03 Median $1,737.80 Typical High $5,623.41 | Facility | None | $309.03 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $309.03 | Professional | None | $131.83 | $239.88 | $309.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $1,778.28 | Facility | None | $323.59 | $489.78 | $1,778.28 |
BCBS Illinois Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $524.81 | Professional | None | $162.18 | $295.12 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $707.95 | Facility | None | $302.00 | $436.52 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $446.68 | Professional | None | $158.49 | $239.88 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $851.14 | Professional | None | $181.97 | $346.74 | $851.14 |
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 $158.49 Median $169.82 Typical High $363.08 | Professional | None | $158.49 | $169.82 | $363.08 |
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 $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 $151.36 Median $269.15 Typical High $524.81 | Professional | None | $151.36 | $269.15 | $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 $66.07 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $66.07 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $26.30 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $97.72 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $19.50 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.18 | $23.99 | $30.90 |
Where Illinois sits
The same service costs 3.1 times more in Wisconsin than in Kentucky. 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· 28th of 51
$282
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.