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 $67.61 Typical High $114.82 | Professional | None | $43.65 | $67.61 | $114.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $1,047.13 | Facility | None | $70.79 | $114.82 | $1,047.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $138.04 | Professional | None | $51.29 | $83.18 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $512.86 | Facility | None | $66.07 | $93.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $162.18 | Professional | None | $56.23 | $95.50 | $162.18 |
Hally Health Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $295.12 | Professional | None | $60.26 | $114.82 | $295.12 |
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 $50.12 Median $54.95 Typical High $107.15 | Professional | None | $50.12 | $54.95 | $107.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $109.65 | Professional | None | $33.11 | $33.11 | $109.65 |
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 $47.86 Median $97.72 Typical High $177.83 | Professional | None | $47.86 | $97.72 | $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 $19.95 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $19.95 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $8.13 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $30.20 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.77 Typical High $12.02 | Professional | 55 · Aftercare only | $6.03 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.07 | $6.46 | $7.94 |
Where Illinois sits
The same service costs 3.2 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· 28th 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.