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 $354.81 Median $1,737.80 Typical High $5,623.41 | Facility | None | $354.81 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $354.81 | Professional | None | $194.98 | $338.84 | $354.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $3,019.95 | Facility | None | $467.74 | $758.58 | $3,019.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $724.44 | Professional | None | $234.42 | $407.38 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $831.76 | Facility | None | $436.52 | $602.56 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $524.81 | Professional | None | $204.17 | $354.81 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $933.25 | Professional | None | $245.47 | $457.09 | $933.25 |
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 $229.09 Median $245.47 Typical High $446.68 | Professional | None | $229.09 | $245.47 | $446.68 |
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 $676.08 Median $1,513.56 Typical High $4,073.80 | Facility | None | $676.08 | $1,513.56 | $4,073.80 |
United Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $645.65 | Professional | None | $213.80 | $354.81 | $645.65 |
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 $97.72 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $97.72 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $38.90 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $147.91 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.50 | $32.36 | $35.48 |
Where Illinois sits
The same service costs 3.0 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· 22nd of 51
$398
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.