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 $512.86 Median $1,905.46 Typical High $6,309.57 | Facility | None | $512.86 | $1,905.46 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $1,698.24 Typical High $2,344.23 | Professional | None | $338.84 | $1,698.24 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $7,762.47 | Facility | None | $1,778.28 | $3,801.89 | $7,762.47 |
BCBS Illinois Setting Professional Modifier None Typical Low $407.38 Median $1,659.59 Typical High $2,691.53 | Professional | None | $407.38 | $1,659.59 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $16,982.44 Typical High $18,620.87 | Facility | None | $8,511.38 | $16,982.44 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $3,162.28 | Professional | None | $371.54 | $575.44 | $3,162.28 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $2,344.23 Typical High $3,630.78 | Professional | None | $457.09 | $2,344.23 | $3,630.78 |
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 $371.54 Median $436.52 Typical High $2,344.23 | Professional | None | $371.54 | $436.52 | $2,344.23 |
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 $371.54 Median $1,047.13 Typical High $3,388.44 | Professional | None | $371.54 | $1,047.13 | $3,388.44 |
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 $181.97 Median $691.83 Typical High $1,023.29 | Professional | 52 · Reduced service | $181.97 | $691.83 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $275.42 Typical High $416.87 | Professional | 53 · Discontinued | $72.44 | $275.42 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,023.29 Typical High $1,548.82 | Professional | 54 · Surgery only | $275.42 | $1,023.29 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $204.17 Typical High $309.03 | Professional | 55 · Aftercare only | $54.95 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $138.04 Typical High $204.17 | Professional | 56 · Pre-op care only | $36.31 | $138.04 | $204.17 |
Where Illinois sits
The same service costs 5.5 times more in Washington 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· 44th of 51
$832
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.