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 $93.33 Median $288.40 Typical High $4,677.35 | Facility | None | $93.33 | $288.40 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $169.82 Typical High $263.03 | Professional | None | $77.62 | $169.82 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $380.19 | Professional | None | $53.70 | $87.10 | $380.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $562.34 Median $1,202.26 Typical High $2,398.83 | Facility | None | $562.34 | $1,202.26 | $2,398.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $85.11 Median $186.21 Typical High $354.81 | Professional | None | $85.11 | $186.21 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $288.40 | Professional | None | $85.11 | $154.88 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $234.42 Typical High $691.83 | Professional | None | $97.72 | $234.42 | $691.83 |
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 $79.43 Median $91.20 Typical High $229.09 | Professional | None | $79.43 | $91.20 | $229.09 |
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 $173.78 Median $1,000.00 Typical High $3,235.94 | Facility | None | $173.78 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $83.18 Median $181.97 Typical High $346.74 | Professional | None | $83.18 | $181.97 | $346.74 |
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 $38.90 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $38.90 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $15.49 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $58.88 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $11.75 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.76 | $16.60 | $19.95 |
Where Illinois sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 29th of 51
$178
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.