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 $446.68 Median $1,819.70 Typical High $5,495.41 | Facility | None | $446.68 | $1,819.70 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,445.44 Typical High $1,819.70 | Professional | None | $309.03 | $1,445.44 | $1,819.70 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,388.44 Median $4,570.88 Typical High $6,456.54 | Facility | None | $3,388.44 | $4,570.88 | $6,456.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $407.38 Median $1,737.80 Typical High $2,570.40 | Professional | None | $407.38 | $1,737.80 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,000.00 Typical High $2,630.27 | Professional | None | $389.05 | $1,000.00 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $2,137.96 Typical High $4,265.80 | Professional | None | $457.09 | $2,137.96 | $4,265.80 |
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 $363.08 Median $426.58 Typical High $2,089.30 | Professional | None | $363.08 | $426.58 | $2,089.30 |
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 $1,862.09 Median $5,495.41 Typical High $10,964.78 | Facility | None | $1,862.09 | $5,495.41 | $10,964.78 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,412.54 Typical High $2,818.38 | Professional | None | $363.08 | $1,412.54 | $2,818.38 |
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 $549.54 Typical High $912.01 | Professional | 52 · Reduced service | $181.97 | $549.54 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $218.78 Typical High $363.08 | Professional | 53 · Discontinued | $72.44 | $218.78 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $831.76 Typical High $1,348.96 | Professional | 54 · Surgery only | $269.15 | $831.76 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $165.96 Typical High $269.15 | Professional | 55 · Aftercare only | $53.70 | $165.96 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $109.65 Typical High $181.97 | Professional | 56 · Pre-op care only | $36.31 | $109.65 | $181.97 |
Where Illinois sits
The same service costs 5.6 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· 30th of 51
$1,479
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.