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 $1,258.93 Typical High $5,623.41 | Facility | None | $109.65 | $1,258.93 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $194.98 | Professional | None | $87.10 | $117.49 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | None | $125.89 | $125.89 | $158.49 |
BCBS Illinois Setting Facility Modifier None Typical Low $104.71 Median $165.96 Typical High $1,174.90 | Facility | None | $104.71 | $165.96 | $1,174.90 |
BCBS Illinois Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $239.88 | Professional | None | $112.20 | $162.18 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $138.04 Typical High $512.86 | Facility | None | $97.72 | $138.04 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $208.93 | Professional | None | $89.13 | $131.83 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $338.84 | Professional | None | $107.15 | $173.78 | $338.84 |
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 $107.15 Median $114.82 Typical High $173.78 | Professional | None | $107.15 | $114.82 | $173.78 |
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 $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $239.88 | Professional | None | $97.72 | $138.04 | $239.88 |
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 $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $41.69 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $16.98 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $63.10 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.32 | $10.72 | $12.59 |
Where Illinois sits
The same service costs 3.7 times more in Alaska 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· 24th 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.