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 $151.36 Median $1,318.26 Typical High $5,623.41 | Facility | None | $151.36 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $154.88 | Professional | None | $61.66 | $141.25 | $154.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $316.23 Median $676.08 Typical High $1,348.96 | Facility | None | $316.23 | $676.08 | $1,348.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $63.10 Median $154.88 Typical High $245.47 | Professional | None | $63.10 | $154.88 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $616.60 | Professional | None | $66.07 | $125.89 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $457.09 | Professional | None | $85.11 | $208.93 | $457.09 |
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 $72.44 Median $77.62 Typical High $199.53 | Professional | None | $72.44 | $77.62 | $199.53 |
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 $67.61 Median $144.54 Typical High $288.40 | Professional | None | $67.61 | $144.54 | $288.40 |
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 $30.90 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $30.90 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $12.30 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $45.71 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $9.12 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.17 | $13.80 | $15.49 |
Where Illinois sits
The same service costs 3.7 times more in Wisconsin 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· 32nd of 51
$148
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.