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 $138.04 Median $1,288.25 Typical High $5,623.41 | Facility | None | $138.04 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $263.03 | Professional | None | $123.03 | $181.97 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $1,548.82 | Facility | None | $190.55 | $309.03 | $1,548.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $371.54 | Professional | None | $131.83 | $213.80 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $257.04 Typical High $537.03 | Facility | None | $177.83 | $257.04 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $323.59 | Professional | None | $141.25 | $213.80 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $549.54 | Professional | None | $151.36 | $263.03 | $549.54 |
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 $141.25 Median $151.36 Typical High $263.03 | Professional | None | $141.25 | $151.36 | $263.03 |
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 $134.90 Median $229.09 Typical High $371.54 | Professional | None | $134.90 | $229.09 | $371.54 |
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 $58.88 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $58.88 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $44.67 | Professional | 53 · Discontinued | $23.44 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $87.10 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $22.39 |
Where Illinois sits
The same service costs 3.0 times more in Wisconsin 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· 29th of 51
$224
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.