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 $138.04 Median $1,348.96 Typical High $5,623.41 | Facility | None | $138.04 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $190.55 | Professional | None | $81.28 | $134.90 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $467.74 Median $691.83 Typical High $1,318.26 | Facility | None | $467.74 | $691.83 | $1,318.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $281.84 | Professional | None | $97.72 | $162.18 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $575.44 Typical High $794.33 | Facility | None | $416.87 | $575.44 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $229.09 | Professional | None | $97.72 | $151.36 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $426.58 | Professional | None | $107.15 | $186.21 | $426.58 |
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 $95.50 Median $100.00 Typical High $181.97 | Professional | None | $95.50 | $100.00 | $181.97 |
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 $446.68 Median $1,047.13 Typical High $3,019.95 | Facility | None | $446.68 | $1,047.13 | $3,019.95 |
United Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $275.42 | Professional | None | $89.13 | $144.54 | $275.42 |
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 $64.57 Typical High $67.61 | Professional | 52 · Reduced service | $40.74 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $26.30 Typical High $27.54 | Professional | 53 · Discontinued | $16.22 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $97.72 Typical High $102.33 | Professional | 54 · Surgery only | $60.26 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $12.02 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.13 | $12.88 | $13.80 |
Where Illinois sits
The same service costs 3.6 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· 31st of 51
$162
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.