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 $371.54 Median $1,174.90 Typical High $5,128.61 | Facility | None | $371.54 | $1,174.90 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $812.83 Typical High $1,348.96 | Professional | None | $257.04 | $812.83 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | None | $245.47 | $245.47 | $251.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,348.96 | $2,884.03 | $5,754.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $295.12 Median $851.14 Typical High $1,202.26 | Professional | None | $295.12 | $851.14 | $1,202.26 |
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 $281.84 Median $426.58 Typical High $1,412.54 | Professional | None | $281.84 | $426.58 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $1,071.52 Typical High $2,137.96 | Professional | None | $346.74 | $1,071.52 | $2,137.96 |
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 $281.84 Median $323.59 Typical High $1,071.52 | Professional | None | $281.84 | $323.59 | $1,071.52 |
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 $281.84 Median $758.58 Typical High $1,737.80 | Professional | None | $281.84 | $758.58 | $1,737.80 |
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 $380.19 Typical High $489.78 | Professional | 52 · Reduced service | $138.04 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $151.36 Typical High $194.98 | Professional | 53 · Discontinued | $54.95 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $562.34 Typical High $724.44 | Professional | 54 · Surgery only | $208.93 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $112.20 Typical High $147.91 | Professional | 55 · Aftercare only | $41.69 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $75.86 Typical High $97.72 | Professional | 56 · Pre-op care only | $27.54 | $75.86 | $97.72 |
Where Illinois sits
The same service costs 4.3 times more in Wisconsin 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· 40th of 51
$661
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.