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 $79.43 Median $436.52 Typical High $5,128.61 | Facility | None | $79.43 | $436.52 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $95.50 Typical High $158.49 | Professional | None | $52.48 | $95.50 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
BCBS Illinois Setting Facility Modifier None Typical Low $102.33 Median $165.96 Typical High $812.83 | Facility | None | $102.33 | $165.96 | $812.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $204.17 | Professional | None | $63.10 | $117.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $138.04 Typical High $512.86 | Facility | None | $97.72 | $138.04 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $162.18 | Professional | None | $63.10 | $97.72 | $162.18 |
Hally Health Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $263.03 | Professional | None | $72.44 | $131.83 | $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 $61.66 Median $66.07 Typical High $131.83 | Professional | None | $61.66 | $66.07 | $131.83 |
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 $58.88 Median $104.71 Typical High $190.55 | Professional | None | $58.88 | $104.71 | $190.55 |
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 $25.70 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $25.70 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $10.47 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $67.61 Typical High $72.44 | Professional | 54 · Surgery only | $38.90 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.49 Typical High $14.45 | Professional | 55 · Aftercare only | $7.76 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $9.12 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.25 | $9.12 | $9.77 |
Where Illinois sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 35th of 51
$102
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.