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 $239.88 Median $1,288.25 Typical High $5,623.41 | Facility | None | $239.88 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $251.19 | Professional | None | $112.20 | $208.93 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $354.81 Median $954.99 Typical High $1,737.80 | Facility | None | $354.81 | $954.99 | $1,737.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $125.89 Median $269.15 Typical High $416.87 | Professional | None | $125.89 | $269.15 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $416.87 | Professional | None | $128.82 | $239.88 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $977.24 | Professional | None | $158.49 | $354.81 | $977.24 |
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 $141.25 Median $147.91 Typical High $331.13 | Professional | None | $141.25 | $147.91 | $331.13 |
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 $831.76 Median $1,862.09 Typical High $3,981.07 | Facility | None | $831.76 | $1,862.09 | $3,981.07 |
United Setting Professional Modifier None Typical Low $128.82 Median $263.03 Typical High $478.63 | Professional | None | $128.82 | $263.03 | $478.63 |
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 $56.23 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $56.23 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $22.39 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $85.11 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $16.98 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.22 | $20.89 | $25.12 |
Where Illinois sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 29th of 51
$251
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.