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 $109.65 Median $436.52 Typical High $5,128.61 | Facility | None | $109.65 | $436.52 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $204.17 | Professional | None | $83.18 | $120.23 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $1,148.15 | Facility | None | $114.82 | $186.21 | $1,148.15 |
BCBS Illinois Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $263.03 | Professional | None | $112.20 | $165.96 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $524.81 | Facility | None | $107.15 | $154.88 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $229.09 | Professional | None | $95.50 | $134.90 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $398.11 | Professional | None | $112.20 | $190.55 | $398.11 |
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 $104.71 Median $114.82 Typical High $181.97 | Professional | None | $104.71 | $114.82 | $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 $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 $100.00 Median $141.25 Typical High $251.19 | Professional | None | $100.00 | $141.25 | $251.19 |
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 $41.69 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $41.69 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $16.60 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $63.10 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $12.30 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.32 | $11.22 | $12.88 |
Where Illinois sits
The same service costs 3.3 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· 27th of 51
$148
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.