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 $602.56 Median $1,819.70 Typical High $5,623.41 | Facility | None | $602.56 | $1,819.70 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,174.90 Typical High $1,621.81 | Professional | None | $281.84 | $1,174.90 | $1,621.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,570.40 Median $4,570.88 Typical High $5,623.41 | Facility | None | $2,570.40 | $4,570.88 | $5,623.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $295.12 Median $1,230.27 Typical High $1,905.46 | Professional | None | $295.12 | $1,230.27 | $1,905.46 |
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 $309.03 Median $812.83 Typical High $2,187.76 | Professional | None | $309.03 | $812.83 | $2,187.76 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $1,659.59 Typical High $2,691.53 | Professional | None | $346.74 | $1,659.59 | $2,691.53 |
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 $288.40 Median $323.59 Typical High $1,621.81 | Professional | None | $288.40 | $323.59 | $1,621.81 |
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 $288.40 Median $1,230.27 Typical High $2,511.89 | Professional | None | $288.40 | $1,230.27 | $2,511.89 |
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 $141.25 Median $512.86 Typical High $741.31 | Professional | 52 · Reduced service | $141.25 | $512.86 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $204.17 Typical High $295.12 | Professional | 53 · Discontinued | $56.23 | $204.17 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $776.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $208.93 | $776.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $154.88 Typical High $223.87 | Professional | 55 · Aftercare only | $41.69 | $154.88 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $102.33 Typical High $147.91 | Professional | 56 · Pre-op care only | $28.18 | $102.33 | $147.91 |
Where Illinois sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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
$1,230
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.