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 $251.19 Median $1,122.02 Typical High $5,128.61 | Facility | None | $251.19 | $1,122.02 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $549.54 Typical High $851.14 | Professional | None | $151.36 | $549.54 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $616.60 | Professional | None | $134.90 | $186.21 | $616.60 |
BCBS Illinois Setting Facility Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,951.21 | Facility | None | $851.14 | $1,318.26 | $2,951.21 |
BCBS Illinois Setting Professional Modifier None Typical Low $190.55 Median $724.44 Typical High $1,412.54 | Professional | None | $190.55 | $724.44 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,288.25 | Facility | None | $676.08 | $1,023.29 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $426.58 Typical High $1,071.52 | Professional | None | $181.97 | $426.58 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $912.01 Typical High $1,819.70 | Professional | None | $229.09 | $912.01 | $1,819.70 |
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 $190.55 Median $213.80 Typical High $891.25 | Professional | None | $190.55 | $213.80 | $891.25 |
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 $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $177.83 Median $588.84 Typical High $1,202.26 | Professional | None | $177.83 | $588.84 | $1,202.26 |
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 $208.93 Typical High $407.38 | Professional | 52 · Reduced service | $91.20 | $208.93 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $83.18 Typical High $162.18 | Professional | 53 · Discontinued | $36.31 | $83.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $309.03 Typical High $616.60 | Professional | 54 · Surgery only | $138.04 | $309.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $61.66 Typical High $123.03 | Professional | 55 · Aftercare only | $27.54 | $61.66 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $41.69 Typical High $81.28 | Professional | 56 · Pre-op care only | $18.20 | $41.69 | $81.28 |
Where Illinois sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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
$617
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.