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 $346.74 Median $1,445.44 Typical High $5,623.41 | Facility | None | $346.74 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | None | $138.04 | $158.49 | $158.49 |
BCBS Illinois Setting Facility Modifier None Typical Low $371.54 Median $562.34 Typical High $2,187.76 | Facility | None | $371.54 | $562.34 | $2,187.76 |
BCBS Illinois Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $288.40 | Professional | None | $158.49 | $251.19 | $288.40 |
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 $138.04 Median $173.78 Typical High $234.42 | Professional | None | $138.04 | $173.78 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $588.84 | Professional | None | $134.90 | $194.98 | $588.84 |
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 $138.04 Median $162.18 Typical High $181.97 | Professional | None | $138.04 | $162.18 | $181.97 |
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 $125.89 Median $147.91 Typical High $251.19 | Professional | None | $125.89 | $147.91 | $251.19 |
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 $69.18 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $27.54 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $20.89 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.80 | $15.85 | $15.85 |
Where Illinois sits
The same service costs 5.1 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· 30th of 51
$158
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.