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 $40.74 Median $131.83 Typical High $162.18 | Professional | None | $40.74 | $131.83 | $162.18 |
BCBS Illinois Setting Facility Modifier None Typical Low $389.05 Median $1,202.26 Typical High $1,584.89 | Facility | None | $389.05 | $1,202.26 | $1,584.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $44.67 Median $125.89 Typical High $223.87 | Professional | None | $44.67 | $125.89 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $269.15 | Professional | None | $33.88 | $60.26 | $269.15 |
Hally Health Setting Professional Modifier None Typical Low $47.86 Median $186.21 Typical High $354.81 | Professional | None | $47.86 | $186.21 | $354.81 |
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 $48.98 Median $50.12 Typical High $204.17 | Professional | None | $48.98 | $50.12 | $204.17 |
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 $40.74 Median $100.00 Typical High $275.42 | Professional | None | $40.74 | $100.00 | $275.42 |
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 $20.42 Median $58.88 Typical High $81.28 | Professional | 52 · Reduced service | $20.42 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $23.44 Typical High $32.36 | Professional | 53 · Discontinued | $8.13 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $89.13 Typical High $120.23 | Professional | 54 · Surgery only | $30.20 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $17.78 Typical High $24.55 | Professional | 55 · Aftercare only | $6.17 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $4.07 | $11.75 | $16.22 |
Where Illinois sits
The same service costs 4.6 times more in Wisconsin 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· 47th of 51
$75.86
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.