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 $223.87 Median $1,778.28 Typical High $5,623.41 | Facility | None | $223.87 | $1,778.28 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $1,659.59 Typical High $2,344.23 | Professional | None | $165.96 | $1,659.59 | $2,344.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,202.26 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,202.26 | $2,570.40 | $5,128.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $177.83 Median $724.44 Typical High $3,311.31 | Professional | None | $177.83 | $724.44 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $812.83 Typical High $16,982.44 | Facility | None | $660.69 | $812.83 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $436.52 Typical High $2,951.21 | Professional | None | $181.97 | $436.52 | $2,951.21 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $2,089.30 Typical High $4,265.80 | Professional | None | $190.55 | $2,089.30 | $4,265.80 |
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 $165.96 Median $190.55 Typical High $2,089.30 | Professional | None | $165.96 | $190.55 | $2,089.30 |
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 $1,412.54 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,412.54 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $177.83 Median $1,258.93 Typical High $3,090.30 | Professional | None | $177.83 | $1,258.93 | $3,090.30 |
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 $83.18 Median $239.88 Typical High $977.24 | Professional | 52 · Reduced service | $83.18 | $239.88 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $97.72 Typical High $398.11 | Professional | 53 · Discontinued | $33.11 | $97.72 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $363.08 Typical High $1,479.11 | Professional | 54 · Surgery only | $123.03 | $363.08 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $72.44 Typical High $295.12 | Professional | 55 · Aftercare only | $24.55 | $72.44 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $147.91 Typical High $194.98 | Professional | 56 · Pre-op care only | $16.60 | $147.91 | $194.98 |
Where Illinois sits
The same service costs 11.2 times more in Oklahoma 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· 26th of 51
$1,778
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.