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 $194.98 Median $1,348.96 Typical High $5,623.41 | Facility | None | $194.98 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $177.83 Typical High $199.53 | Professional | None | $85.11 | $177.83 | $199.53 |
BCBS Illinois Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $1,548.82 | Facility | None | $213.80 | $346.74 | $1,548.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $269.15 | Professional | None | $85.11 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $812.83 | Facility | None | $199.53 | $288.40 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $323.59 | Professional | None | $93.33 | $181.97 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $245.47 Typical High $562.34 | Professional | None | $107.15 | $245.47 | $562.34 |
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 $95.50 Median $104.71 Typical High $257.04 | Professional | None | $95.50 | $104.71 | $257.04 |
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 $3,981.07 | Facility | None | $676.08 | $1,513.56 | $3,981.07 |
United Setting Professional Modifier None Typical Low $91.20 Median $186.21 Typical High $346.74 | Professional | None | $91.20 | $186.21 | $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 $42.66 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $42.66 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $16.98 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $123.03 Typical High $144.54 | Professional | 54 · Surgery only | $63.10 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $24.55 Typical High $28.84 | Professional | 55 · Aftercare only | $12.59 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $8.51 | $16.60 | $19.50 |
Where Illinois sits
The same service costs 3.7 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· 28th of 51
$182
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.