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 $213.80 Median $1,348.96 Typical High $5,623.41 | Facility | None | $213.80 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $223.87 | Professional | None | $81.28 | $154.88 | $223.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Facility | None | $758.58 | $1,000.00 | $1,513.56 |
BCBS Illinois Setting Professional Modifier None Typical Low $91.20 Median $229.09 Typical High $323.59 | Professional | None | $91.20 | $229.09 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $933.25 Typical High $1,202.26 | Facility | None | $478.63 | $933.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $380.19 | Professional | None | $97.72 | $173.78 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $104.71 Median $269.15 Typical High $416.87 | Professional | None | $104.71 | $269.15 | $416.87 |
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 $93.33 Median $102.33 Typical High $288.40 | Professional | None | $93.33 | $102.33 | $288.40 |
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 $4,073.80 | Facility | None | $676.08 | $1,513.56 | $4,073.80 |
United Setting Professional Modifier None Typical Low $87.10 Median $173.78 Typical High $354.81 | Professional | None | $87.10 | $173.78 | $354.81 |
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 $40.74 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $40.74 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $16.22 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $61.66 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $23.44 Typical High $33.88 | Professional | 55 · Aftercare only | $12.30 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.13 | $15.49 | $22.39 |
Where Illinois sits
The same service costs 4.1 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· 37th of 51
$174
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.