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 $85.11 Median $436.52 Typical High $5,128.61 | Facility | None | $85.11 | $436.52 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $107.15 | Professional | None | $66.07 | $87.10 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $1,023.29 | Facility | None | $70.79 | $114.82 | $1,023.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $204.17 | Professional | None | $75.86 | $125.89 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $512.86 | Facility | None | $66.07 | $95.50 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $151.36 | Professional | None | $69.18 | $87.10 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $269.15 | Professional | None | $81.28 | $123.03 | $269.15 |
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 $74.13 Median $81.28 Typical High $120.23 | Professional | None | $74.13 | $81.28 | $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 $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 $69.18 Median $107.15 Typical High $181.97 | Professional | None | $69.18 | $107.15 | $181.97 |
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 $33.11 Median $43.65 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $13.18 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $64.57 Typical High $67.61 | Professional | 54 · Surgery only | $48.98 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.88 Typical High $13.49 | Professional | 55 · Aftercare only | $9.77 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.61 | $8.71 | $9.12 |
Where Illinois sits
The same service costs 3.5 times more in Wisconsin 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· 22nd of 51
$112
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.