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 $138.04 Median $1,202.26 Typical High $7,762.47 | Facility | None | $138.04 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $204.17 | Professional | None | $120.23 | $144.54 | $204.17 |
BCBS Illinois Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $1,778.28 | Facility | None | $100.00 | $162.18 | $1,778.28 |
BCBS Illinois Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $309.03 | Professional | None | $169.82 | $239.88 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $125.89 Typical High $218.78 | Facility | None | $69.18 | $125.89 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | None | $151.36 | $177.83 | $295.12 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $575.44 | Professional | None | $151.36 | $234.42 | $575.44 |
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 $144.54 Median $173.78 Typical High $229.09 | Professional | None | $144.54 | $173.78 | $229.09 |
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 $60.26 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $60.26 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $23.99 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $123.03 | Professional | 54 · Surgery only | $91.20 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $24.55 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $16.22 |
Where Illinois sits
The same service costs 2.9 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· 18th of 51
$204
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.