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 $41.69 Median $1,202.26 Typical High $7,762.47 | Facility | None | $41.69 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $109.65 | Professional | None | $41.69 | $74.13 | $109.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $1,071.52 | Facility | None | $169.82 | $208.93 | $1,071.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $169.82 | Professional | None | $47.86 | $91.20 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $69.18 Typical High $125.89 | Professional | None | $42.66 | $69.18 | $125.89 |
Hally Health Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $223.87 | Professional | None | $53.70 | $100.00 | $223.87 |
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 $47.86 Median $50.12 Typical High $100.00 | Professional | None | $47.86 | $50.12 | $100.00 |
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 $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $138.04 | Professional | None | $43.65 | $77.62 | $138.04 |
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 $20.89 Median $34.67 Typical High $37.15 | Professional | 52 · Reduced service | $20.89 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.80 Typical High $14.79 | Professional | 53 · Discontinued | $8.32 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $52.48 Typical High $56.23 | Professional | 54 · Surgery only | $30.90 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $11.22 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.92 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.17 | $6.92 | $7.41 |
Where Illinois sits
The same service costs 3.4 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· 36th of 51
$77.62
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.