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 $354.81 Median $1,445.44 Typical High $5,623.41 | Facility | None | $354.81 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | None | $181.97 | $194.98 | $194.98 |
BCBS Illinois Setting Facility Modifier None Typical Low $371.54 Median $562.34 Typical High $2,691.53 | Facility | None | $371.54 | $562.34 | $2,691.53 |
BCBS Illinois Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $302.00 | Professional | None | $173.78 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Facility | None | $346.74 | $467.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $257.04 | Professional | None | $134.90 | $186.21 | $257.04 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $1,202.26 | Professional | None | $162.18 | $239.88 | $1,202.26 |
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 $199.53 Median $208.93 Typical High $223.87 | Professional | None | $199.53 | $208.93 | $223.87 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $316.23 | Professional | None | $123.03 | $169.82 | $316.23 |
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 $91.20 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $36.31 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $18.20 | $19.50 | $19.50 |
Where Illinois sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 28th of 51
$195
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.