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 $309.03 Median $1,584.89 Typical High $5,623.41 | Facility | None | $309.03 | $1,584.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $1,122.02 Typical High $1,479.11 | Professional | None | $239.88 | $1,122.02 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $1,288.25 | Professional | None | $114.82 | $208.93 | $1,288.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,258.93 Median $2,691.53 Typical High $5,370.32 | Facility | None | $1,258.93 | $2,691.53 | $5,370.32 |
BCBS Illinois Setting Professional Modifier None Typical Low $269.15 Median $1,122.02 Typical High $1,621.81 | Professional | None | $269.15 | $1,122.02 | $1,621.81 |
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 $263.03 Median $389.05 Typical High $1,995.26 | Professional | None | $263.03 | $389.05 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $1,548.82 Typical High $2,398.83 | Professional | None | $323.59 | $1,548.82 | $2,398.83 |
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 $263.03 Median $302.00 Typical High $1,548.82 | Professional | None | $263.03 | $302.00 | $1,548.82 |
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 $263.03 Median $758.58 Typical High $2,344.23 | Professional | None | $263.03 | $758.58 | $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 $128.82 Median $501.19 Typical High $724.44 | Professional | 52 · Reduced service | $128.82 | $501.19 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $199.53 Typical High $288.40 | Professional | 53 · Discontinued | $51.29 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $741.31 Typical High $1,071.52 | Professional | 54 · Surgery only | $194.98 | $741.31 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $147.91 Typical High $213.80 | Professional | 55 · Aftercare only | $38.90 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $100.00 Typical High $144.54 | Professional | 56 · Pre-op care only | $25.70 | $100.00 | $144.54 |
Where Illinois sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$631
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.