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 $58.88 Median $331.13 Typical High $4,677.35 | Facility | None | $58.88 | $331.13 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $87.10 Typical High $128.82 | Professional | None | $44.67 | $87.10 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | None | $81.28 | $93.33 | $93.33 |
BCBS Illinois Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,288.25 | Facility | None | $602.56 | $1,000.00 | $1,288.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $173.78 | Professional | None | $51.29 | $97.72 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $478.63 | Facility | None | $467.74 | $467.74 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $114.82 Typical High $144.54 | Professional | None | $56.23 | $114.82 | $144.54 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $346.74 | Professional | None | $58.88 | $120.23 | $346.74 |
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 $51.29 Median $56.23 Typical High $120.23 | Professional | None | $51.29 | $56.23 | $120.23 |
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 $208.93 Median $1,071.52 Typical High $3,090.30 | Facility | None | $208.93 | $1,071.52 | $3,090.30 |
United Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $162.18 | Professional | None | $50.12 | $100.00 | $162.18 |
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 $22.39 Median $39.81 Typical High $43.65 | Professional | 52 · Reduced service | $22.39 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $16.22 Typical High $17.38 | Professional | 53 · Discontinued | $8.91 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $60.26 Typical High $66.07 | Professional | 54 · Surgery only | $33.11 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.02 Typical High $13.18 | Professional | 55 · Aftercare only | $6.61 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $8.13 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.47 | $8.13 | $8.71 |
Where Illinois sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 26th of 51
$97.72
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.