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 $380.19 Median $1,445.44 Typical High $5,623.41 | Facility | None | $380.19 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $275.42 | Professional | None | $138.04 | $186.21 | $275.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $2,398.83 | Facility | None | $251.19 | $380.19 | $2,398.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $323.59 | Professional | None | $229.09 | $281.84 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $316.23 Typical High $380.19 | Facility | None | $234.42 | $316.23 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $354.81 | Professional | None | $181.97 | $229.09 | $354.81 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $912.01 | Professional | None | $177.83 | $295.12 | $912.01 |
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 $194.98 Median $234.42 Typical High $263.03 | Professional | None | $194.98 | $234.42 | $263.03 |
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 $169.82 Median $245.47 Typical High $407.38 | Professional | None | $169.82 | $245.47 | $407.38 |
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 $69.18 Median $93.33 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $27.54 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $141.25 Typical High $147.91 | Professional | 54 · Surgery only | $104.71 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.62 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.80 | $18.62 | $19.95 |
Where Illinois sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 19th of 51
$263
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.