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 $933.25 Median $4,168.69 Typical High $8,709.64 | Facility | None | $933.25 | $4,168.69 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $4,466.84 | Professional | None | $3,548.13 | $4,168.69 | $4,466.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $18,620.87 Median $39,810.72 Typical High $79,432.82 | Facility | None | $18,620.87 | $39,810.72 | $79,432.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $4,168.69 Median $5,011.87 Typical High $6,918.31 | Professional | None | $4,168.69 | $5,011.87 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $5,128.61 Typical High $6,760.83 | Professional | None | $3,715.35 | $5,128.61 | $6,760.83 |
Hally Health Setting Professional Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $13,803.84 | Professional | None | $3,311.31 | $5,370.32 | $13,803.84 |
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 $3,715.35 Median $4,365.16 Typical High $4,897.79 | Professional | None | $3,715.35 | $4,365.16 | $4,897.79 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $5,370.32 Typical High $8,128.31 | Professional | None | $3,715.35 | $5,370.32 | $8,128.31 |
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 $1,862.09 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,862.09 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,818.38 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $371.54 | $416.87 | $416.87 |
Where Illinois sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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· 21st of 51
$4,677
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.