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 $467.74 Median $1,737.80 Typical High $5,623.41 | Facility | None | $467.74 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $537.03 Typical High $645.65 | Professional | None | $134.90 | $537.03 | $645.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $2,754.23 | Facility | None | $645.65 | $1,380.38 | $2,754.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $134.90 Median $562.34 Typical High $851.14 | Professional | None | $134.90 | $562.34 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $870.96 | Professional | None | $138.04 | $204.17 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $707.95 Typical High $1,412.54 | Professional | None | $165.96 | $707.95 | $1,412.54 |
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 $154.88 Typical High $707.95 | Professional | None | $141.25 | $154.88 | $707.95 |
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 $173.78 Median $1,000.00 Typical High $3,235.94 | Facility | None | $173.78 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $134.90 Median $380.19 Typical High $977.24 | Professional | None | $134.90 | $380.19 | $977.24 |
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 $67.61 Median $190.55 Typical High $323.59 | Professional | 52 · Reduced service | $67.61 | $190.55 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $77.62 Typical High $128.82 | Professional | 53 · Discontinued | $26.92 | $77.62 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $288.40 Typical High $489.78 | Professional | 54 · Surgery only | $100.00 | $288.40 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $57.54 Typical High $97.72 | Professional | 55 · Aftercare only | $19.95 | $57.54 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $38.90 Typical High $64.57 | Professional | 56 · Pre-op care only | $13.49 | $38.90 | $64.57 |
Where Illinois sits
The same service costs 4.0 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· 44th of 51
$355
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.