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 $38.02 Median $331.13 Typical High $4,677.35 | Facility | None | $38.02 | $331.13 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $75.86 Typical High $125.89 | Professional | None | $30.90 | $75.86 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $72.44 Typical High $93.33 | Professional | None | $23.99 | $72.44 | $93.33 |
BCBS Illinois Setting Facility Modifier None Typical Low $85.11 Median $138.04 Typical High $478.63 | Facility | None | $85.11 | $138.04 | $478.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $34.67 Median $83.18 Typical High $154.88 | Professional | None | $34.67 | $83.18 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $186.21 | Facility | None | $66.07 | $107.15 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $77.62 Typical High $125.89 | Professional | None | $35.48 | $77.62 | $125.89 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $100.00 Typical High $229.09 | Professional | None | $40.74 | $100.00 | $229.09 |
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 $34.67 Median $38.02 Typical High $100.00 | Professional | None | $34.67 | $38.02 | $100.00 |
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 $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $36.31 Median $77.62 Typical High $147.91 | Professional | None | $36.31 | $77.62 | $147.91 |
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 $15.49 Median $34.67 Typical High $38.02 | Professional | 52 · Reduced service | $15.49 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $14.13 Typical High $15.14 | Professional | 53 · Discontinued | $6.17 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $52.48 Typical High $57.54 | Professional | 54 · Surgery only | $22.91 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $10.47 Typical High $11.48 | Professional | 55 · Aftercare only | $4.57 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.09 | $6.92 | $7.59 |
Where Illinois sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 31st of 51
$83.18
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.