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 $69.18 Median $1,023.29 Typical High $5,888.44 | Facility | None | $69.18 | $1,023.29 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $190.55 | Professional | None | $67.61 | $117.49 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $223.87 | Professional | None | $102.33 | $114.82 | $223.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $117.49 Median $186.21 Typical High $758.58 | Facility | None | $117.49 | $186.21 | $758.58 |
BCBS Illinois Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $213.80 | Professional | None | $67.61 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $144.54 Typical High $251.19 | Facility | None | $79.43 | $144.54 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $194.98 | Professional | None | $74.13 | $125.89 | $194.98 |
Hally Health Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $302.00 | Professional | None | $89.13 | $158.49 | $302.00 |
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 $83.18 Median $87.10 Typical High $162.18 | Professional | None | $83.18 | $87.10 | $162.18 |
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 $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $223.87 | Professional | None | $75.86 | $131.83 | $223.87 |
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 $33.88 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $33.88 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $13.49 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $85.11 Typical High $91.20 | Professional | 54 · Surgery only | $50.12 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.98 Typical High $18.20 | Professional | 55 · Aftercare only | $10.00 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.76 | $11.22 | $12.30 |
Where Illinois sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 24th of 51
$129
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.