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 $147.91 Median $1,096.48 Typical High $5,623.41 | Facility | None | $147.91 | $1,096.48 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $275.42 | Professional | None | $120.23 | $162.18 | $275.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $1,698.24 | Facility | None | $147.91 | $234.42 | $1,698.24 |
BCBS Illinois Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $346.74 | Professional | None | $151.36 | $223.87 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $194.98 Typical High $524.81 | Facility | None | $138.04 | $194.98 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $302.00 | Professional | None | $131.83 | $181.97 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $501.19 | Professional | None | $151.36 | $251.19 | $501.19 |
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 $141.25 Median $154.88 Typical High $245.47 | Professional | None | $141.25 | $154.88 | $245.47 |
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 $446.68 Median $1,047.13 Typical High $3,019.95 | Facility | None | $446.68 | $1,047.13 | $3,019.95 |
United Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $338.84 | Professional | None | $134.90 | $194.98 | $338.84 |
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 $56.23 Median $75.86 Typical High $87.10 | Professional | 52 · Reduced service | $56.23 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $34.67 | Professional | 53 · Discontinued | $22.39 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $131.83 | Professional | 54 · Surgery only | $85.11 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $26.30 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $17.38 |
Where Illinois sits
The same service costs 3.7 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· 26th of 51
$200
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.