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 $79.43 Median $1,318.26 Typical High $5,623.41 | Facility | None | $79.43 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $87.10 | Professional | None | $43.65 | $69.18 | $87.10 |
BCBS Illinois Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $575.44 | Facility | None | $79.43 | $125.89 | $575.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $144.54 | Professional | None | $50.12 | $89.13 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $104.71 Typical High $512.86 | Facility | None | $74.13 | $104.71 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $173.78 | Professional | None | $54.95 | $91.20 | $173.78 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $338.84 | Professional | None | $63.10 | $117.49 | $338.84 |
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 $52.48 Median $57.54 Typical High $109.65 | Professional | None | $52.48 | $57.54 | $109.65 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $114.82 | Professional | None | $33.11 | $33.11 | $114.82 |
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 $46.77 Median $95.50 Typical High $151.36 | Professional | None | $46.77 | $95.50 | $151.36 |
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 $20.89 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $20.89 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.18 Typical High $15.85 | Professional | 53 · Discontinued | $8.32 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $48.98 Typical High $60.26 | Professional | 54 · Surgery only | $31.62 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.77 Typical High $12.02 | Professional | 55 · Aftercare only | $6.31 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.17 | $6.46 | $7.94 |
Where Illinois sits
The same service costs 3.0 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· 34th of 51
$91.20
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.