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 $147.91 Median $776.25 Typical High $5,128.61 | Facility | None | $147.91 | $776.25 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $275.42 | Professional | None | $112.20 | $213.80 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $354.81 Median $954.99 Typical High $1,698.24 | Facility | None | $354.81 | $954.99 | $1,698.24 |
BCBS Illinois Setting Professional Modifier None Typical Low $125.89 Median $263.03 Typical High $436.52 | Professional | None | $125.89 | $263.03 | $436.52 |
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 $234.42 Typical High $407.38 | Professional | None | $128.82 | $234.42 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $158.49 Median $346.74 Typical High $870.96 | Professional | None | $158.49 | $346.74 | $870.96 |
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 $138.04 Median $144.54 Typical High $323.59 | Professional | None | $138.04 | $144.54 | $323.59 |
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 $125.89 Median $257.04 Typical High $457.09 | Professional | None | $125.89 | $257.04 | $457.09 |
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 $54.95 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $54.95 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $151.36 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $20.42 | $24.55 |
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· 31st of 51
$245
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.