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 $436.52 Median $1,479.11 Typical High $5,623.41 | Facility | None | $436.52 | $1,479.11 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,122.02 Typical High $1,698.24 | Professional | None | $263.03 | $1,122.02 | $1,698.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $5,888.44 | Facility | None | $1,380.38 | $2,951.21 | $5,888.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $316.23 Median $1,584.89 Typical High $2,398.83 | Professional | None | $316.23 | $1,584.89 | $2,398.83 |
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 $295.12 Median $794.33 Typical High $2,290.87 | Professional | None | $295.12 | $794.33 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $1,778.28 Typical High $3,090.30 | Professional | None | $354.81 | $1,778.28 | $3,090.30 |
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 $269.15 Median $331.13 Typical High $1,737.80 | Professional | None | $269.15 | $331.13 | $1,737.80 |
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 $275.42 Median $1,148.15 Typical High $2,344.23 | Professional | None | $275.42 | $1,148.15 | $2,344.23 |
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 $138.04 Median $457.09 Typical High $741.31 | Professional | 52 · Reduced service | $138.04 | $457.09 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $181.97 Typical High $295.12 | Professional | 53 · Discontinued | $54.95 | $181.97 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $691.83 Typical High $1,096.48 | Professional | 54 · Surgery only | $208.93 | $691.83 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $138.04 Typical High $218.78 | Professional | 55 · Aftercare only | $41.69 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $91.20 Typical High $147.91 | Professional | 56 · Pre-op care only | $27.54 | $91.20 | $147.91 |
Where Illinois sits
The same service costs 6.5 times more in Washington 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· 29th of 51
$1,175
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.