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 $338.84 Median $3,235.94 Typical High $9,332.54 | Facility | None | $338.84 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $245.47 | Professional | None | $107.15 | $141.25 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $4,677.35 | Facility | None | $1,995.26 | $3,235.94 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $239.88 | Professional | None | $169.82 | $229.09 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $3,890.45 | Facility | None | $1,023.29 | $3,162.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $251.19 | Professional | None | $141.25 | $186.21 | $251.19 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $562.34 | Professional | None | $141.25 | $218.78 | $562.34 |
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 $147.91 Median $173.78 Typical High $199.53 | Professional | None | $147.91 | $173.78 | $199.53 |
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 $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $309.03 | Professional | None | $125.89 | $181.97 | $309.03 |
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 $51.29 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $51.29 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $20.42 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $77.62 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $15.49 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.23 | $14.13 | $14.79 |
Where Illinois sits
The same service costs 10.7 times more in Oklahoma than in New York. 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
$209
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.