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 $58.88 Median $346.74 Typical High $4,677.35 | Facility | None | $58.88 | $346.74 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $147.91 | Professional | None | $42.66 | $75.86 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $120.23 Typical High $151.36 | Professional | None | $36.31 | $120.23 | $151.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $776.25 | Facility | None | $169.82 | $208.93 | $776.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $47.86 Median $112.20 Typical High $169.82 | Professional | None | $47.86 | $112.20 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $251.19 Typical High $812.83 | Facility | None | $50.12 | $251.19 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $61.66 Typical High $199.53 | Professional | None | $30.20 | $61.66 | $199.53 |
Hally Health Setting Professional Modifier None Typical Low $50.12 Median $134.90 Typical High $263.03 | Professional | None | $50.12 | $134.90 | $263.03 |
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 $51.29 Typical High $151.36 | Professional | None | $48.98 | $51.29 | $151.36 |
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 $141.25 Median $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $40.74 Median $83.18 Typical High $181.97 | Professional | None | $40.74 | $83.18 | $181.97 |
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 $21.38 Median $38.02 Typical High $60.26 | Professional | 52 · Reduced service | $21.38 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $15.14 Typical High $23.99 | Professional | 53 · Discontinued | $8.51 | $15.14 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $57.54 Typical High $89.13 | Professional | 54 · Surgery only | $31.62 | $57.54 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $11.48 Typical High $17.78 | Professional | 55 · Aftercare only | $6.31 | $11.48 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.59 Typical High $12.02 | Professional | 56 · Pre-op care only | $4.27 | $7.59 | $12.02 |
Where Illinois sits
The same service costs 3.4 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· 41st of 51
$77.62
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.