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 $74.13 Median $1,047.13 Typical High $5,623.41 | Facility | None | $74.13 | $1,047.13 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $158.49 | Professional | None | $63.10 | $100.00 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $112.20 Typical High $141.25 | Professional | None | $52.48 | $112.20 | $141.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $812.83 | Facility | None | $79.43 | $125.89 | $812.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $213.80 | Professional | None | $75.86 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $169.82 | Facility | None | $63.10 | $97.72 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $177.83 | Professional | None | $79.43 | $117.49 | $177.83 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $295.12 | Professional | None | $85.11 | $144.54 | $295.12 |
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 $72.44 Median $81.28 Typical High $138.04 | Professional | None | $72.44 | $81.28 | $138.04 |
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 $75.86 Median $120.23 Typical High $194.98 | Professional | None | $75.86 | $120.23 | $194.98 |
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 $29.51 Median $43.65 Typical High $50.12 | Professional | 52 · Reduced service | $29.51 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $17.38 Typical High $19.95 | Professional | 53 · Discontinued | $11.75 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $64.57 Typical High $74.13 | Professional | 54 · Surgery only | $44.67 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.88 Typical High $14.79 | Professional | 55 · Aftercare only | $8.91 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.71 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.89 | $8.71 | $10.00 |
Where Illinois sits
The same service costs 3.0 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· 23rd of 51
$120
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.