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 $64.57 Median $1,148.15 Typical High $5,623.41 | Facility | None | $64.57 | $1,148.15 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $104.71 Typical High $158.49 | Professional | None | $48.98 | $104.71 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
BCBS Illinois Setting Facility Modifier None Typical Low $181.97 Median $263.03 Typical High $1,348.96 | Facility | None | $181.97 | $263.03 | $1,348.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $54.95 Median $131.83 Typical High $199.53 | Professional | None | $54.95 | $131.83 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $933.25 | Facility | None | $169.82 | $239.88 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $77.62 Typical High $234.42 | Professional | None | $29.51 | $77.62 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $158.49 Typical High $331.13 | Professional | None | $58.88 | $158.49 | $331.13 |
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 $56.23 Median $61.66 Typical High $173.78 | Professional | None | $56.23 | $61.66 | $173.78 |
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 $446.68 Median $1,047.13 Typical High $3,019.95 | Facility | None | $446.68 | $1,047.13 | $3,019.95 |
United Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $218.78 | Professional | None | $51.29 | $104.71 | $218.78 |
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 $24.55 Median $53.70 Typical High $64.57 | Professional | 52 · Reduced service | $24.55 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $21.38 Typical High $25.70 | Professional | 53 · Discontinued | $9.77 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $79.43 Typical High $97.72 | Professional | 54 · Surgery only | $37.15 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $16.22 Typical High $19.50 | Professional | 55 · Aftercare only | $7.41 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $10.72 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.90 | $10.72 | $12.88 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 43rd of 51
$91.20
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.