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 $1,318.26 Typical High $5,623.41 | Facility | None | $346.74 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $363.08 Typical High $588.84 | Professional | None | $89.13 | $363.08 | $588.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,348.96 | Facility | None | $524.81 | $758.58 | $1,348.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $93.33 Median $281.84 Typical High $741.31 | Professional | None | $93.33 | $281.84 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $676.08 Typical High $933.25 | Facility | None | $489.78 | $676.08 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $234.42 Typical High $602.56 | Professional | None | $95.50 | $234.42 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $478.63 Typical High $1,737.80 | Professional | None | $112.20 | $478.63 | $1,737.80 |
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 $93.33 Median $102.33 Typical High $478.63 | Professional | None | $93.33 | $102.33 | $478.63 |
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 $446.68 Median $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $102.33 Median $363.08 Typical High $831.76 | Professional | None | $102.33 | $363.08 | $831.76 |
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 $44.67 Median $131.83 Typical High $218.78 | Professional | 52 · Reduced service | $44.67 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $52.48 Typical High $87.10 | Professional | 53 · Discontinued | $17.78 | $52.48 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $66.07 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $13.49 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $26.30 Typical High $43.65 | Professional | 56 · Pre-op care only | $8.91 | $26.30 | $43.65 |
Where Illinois sits
The same service costs 7.8 times more in Oklahoma 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· 26th of 51
$437
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.