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 $1,819.70 Typical High $5,623.41 | Facility | None | $512.86 | $1,819.70 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $741.31 Typical High $870.96 | Professional | None | $204.17 | $741.31 | $870.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,995.26 Median $4,570.88 Typical High $6,165.95 | Facility | None | $1,995.26 | $4,570.88 | $6,165.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $223.87 Median $831.76 Typical High $1,412.54 | Professional | None | $223.87 | $831.76 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $575.44 Typical High $1,288.25 | Professional | None | $234.42 | $575.44 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $281.84 Median $1,096.48 Typical High $1,584.89 | Professional | None | $281.84 | $1,096.48 | $1,584.89 |
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 $245.47 Median $263.03 Typical High $1,071.52 | Professional | None | $245.47 | $263.03 | $1,071.52 |
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 $1,862.09 Median $5,495.41 Typical High $11,220.18 | Facility | None | $1,862.09 | $5,495.41 | $11,220.18 |
United Setting Professional Modifier None Typical Low $229.09 Median $776.25 Typical High $1,513.56 | Professional | None | $229.09 | $776.25 | $1,513.56 |
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 $102.33 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $102.33 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $138.04 Typical High $165.96 | Professional | 53 · Discontinued | $41.69 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $512.86 Typical High $630.96 | Professional | 54 · Surgery only | $154.88 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $30.90 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $20.42 | $69.18 | $83.18 |
Where Illinois sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 27th of 51
$776
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.