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 $77.62 Median $1,258.93 Typical High $5,623.41 | Facility | None | $77.62 | $1,258.93 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $134.90 | Professional | None | $54.95 | $74.13 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $85.11 | Professional | None | $46.77 | $58.88 | $85.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $1,174.90 | Facility | None | $77.62 | $123.03 | $1,174.90 |
BCBS Illinois Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $165.96 | Professional | None | $60.26 | $100.00 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $512.86 | Facility | None | $72.44 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $169.82 | Professional | None | $63.10 | $93.33 | $169.82 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $398.11 | Professional | None | $75.86 | $123.03 | $398.11 |
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 $66.07 Median $70.79 Typical High $114.82 | Professional | None | $66.07 | $70.79 | $114.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $128.82 | Professional | None | $33.11 | $33.11 | $128.82 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $177.83 | Professional | None | $60.26 | $102.33 | $177.83 |
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 $26.30 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $26.30 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.13 Typical High $16.98 | Professional | 53 · Discontinued | $10.47 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $39.81 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.08 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.25 | $7.08 | $8.51 |
Where Illinois sits
The same service costs 3.2 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· 34th of 51
$93.33
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.