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 $15.85 Median $28.84 Typical High $45.71 | Facility | None | $15.85 | $28.84 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $28.18 Typical High $37.15 | Professional | None | $16.22 | $28.18 | $37.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $398.11 | Facility | None | $169.82 | $190.55 | $398.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $15.85 Median $29.51 Typical High $57.54 | Professional | None | $15.85 | $29.51 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $251.19 Typical High $812.83 | Facility | None | $50.12 | $251.19 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $28.18 Typical High $46.77 | Professional | None | $16.22 | $28.18 | $46.77 |
Hally Health Setting Professional Modifier None Typical Low $19.50 Median $37.15 Typical High $95.50 | Professional | None | $19.50 | $37.15 | $95.50 |
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 $17.78 Median $18.62 Typical High $35.48 | Professional | None | $17.78 | $18.62 | $35.48 |
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 $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $54.95 | Professional | None | $16.60 | $31.62 | $54.95 |
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 $8.13 Median $13.49 Typical High $16.22 | Professional | 52 · Reduced service | $8.13 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $5.37 Typical High $6.46 | Professional | 53 · Discontinued | $3.31 | $5.37 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $20.42 Typical High $23.99 | Professional | 54 · Surgery only | $12.30 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $4.07 Typical High $4.79 | Professional | 55 · Aftercare only | $2.45 | $4.07 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.69 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.62 | $2.69 | $3.24 |
Where Illinois sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 36th of 51
$32.36
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.