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 $302.00 Median $1,348.96 Typical High $5,623.41 | Facility | None | $302.00 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $309.03 | Professional | None | $100.00 | $251.19 | $309.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $724.44 Median $1,548.82 Typical High $3,090.30 | Facility | None | $724.44 | $1,548.82 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $426.58 | Professional | None | $104.71 | $223.87 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $331.13 Typical High $1,230.27 | Professional | None | $123.03 | $331.13 | $1,230.27 |
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 $100.00 Median $114.82 Typical High $331.13 | Professional | None | $100.00 | $114.82 | $331.13 |
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 $138.04 Median $457.09 Typical High $1,949.84 | Facility | None | $138.04 | $457.09 | $1,949.84 |
United Setting Professional Modifier None Typical Low $102.33 Median $269.15 Typical High $562.34 | Professional | None | $102.33 | $269.15 | $562.34 |
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 $48.98 Median $100.00 Typical High $151.36 | Professional | 52 · Reduced service | $48.98 | $100.00 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $39.81 Typical High $60.26 | Professional | 53 · Discontinued | $19.95 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $223.87 | Professional | 54 · Surgery only | $74.13 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $29.51 Typical High $45.71 | Professional | 55 · Aftercare only | $14.79 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.95 Typical High $30.20 | Professional | 56 · Pre-op care only | $10.00 | $19.95 | $30.20 |
Where Illinois sits
The same service costs 3.6 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· 18th of 51
$295
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.