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 $512.86 Median $1,905.46 Typical High $5,888.44 | Facility | None | $512.86 | $1,905.46 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $371.54 | Professional | None | $346.74 | $354.81 | $371.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $3,890.45 | Facility | None | $1,348.96 | $1,995.26 | $3,890.45 |
BCBS Illinois Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $588.84 | Professional | None | $371.54 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $2,398.83 | Facility | None | $630.96 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $602.56 | Professional | None | $380.19 | $457.09 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $2,137.96 | Professional | None | $371.54 | $537.03 | $2,137.96 |
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 $416.87 Median $446.68 Typical High $478.63 | Professional | None | $416.87 | $446.68 | $478.63 |
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 $1,047.13 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $724.44 | Professional | None | $380.19 | $478.63 | $724.44 |
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 $173.78 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $35.48 |
Where Illinois sits
The same service costs 4.8 times more in Alaska 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· 30th of 51
$457
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.