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 $186.21 Median $1,122.02 Typical High $5,623.41 | Facility | None | $186.21 | $1,122.02 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $575.44 Typical High $758.58 | Professional | None | $154.88 | $575.44 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $389.05 Typical High $1,000.00 | Professional | None | $120.23 | $389.05 | $1,000.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $758.58 Median $1,621.81 Typical High $3,235.94 | Facility | None | $758.58 | $1,621.81 | $3,235.94 |
BCBS Illinois Setting Professional Modifier None Typical Low $165.96 Median $588.84 Typical High $891.25 | Professional | None | $165.96 | $588.84 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $954.99 | Professional | None | $158.49 | $251.19 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $741.31 Typical High $1,288.25 | Professional | None | $194.98 | $741.31 | $1,288.25 |
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 $154.88 Median $181.97 Typical High $741.31 | Professional | None | $154.88 | $181.97 | $741.31 |
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 $158.49 Median $436.52 Typical High $1,071.52 | Professional | None | $158.49 | $436.52 | $1,071.52 |
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 $77.62 Median $229.09 Typical High $346.74 | Professional | 52 · Reduced service | $77.62 | $229.09 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $91.20 Typical High $138.04 | Professional | 53 · Discontinued | $30.90 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $346.74 Typical High $512.86 | Professional | 54 · Surgery only | $114.82 | $346.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $69.18 Typical High $104.71 | Professional | 55 · Aftercare only | $22.91 | $69.18 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $45.71 Typical High $69.18 | Professional | 56 · Pre-op care only | $15.49 | $45.71 | $69.18 |
Where Illinois sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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· 43rd of 51
$398
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.