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 $47.86 Median $125.89 Typical High $4,168.69 | Facility | None | $47.86 | $125.89 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $107.15 | Professional | None | $38.02 | $67.61 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $28.84 Median $51.29 Typical High $60.26 | Professional | None | $28.84 | $51.29 | $60.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $83.18 Median $131.83 Typical High $1,047.13 | Facility | None | $83.18 | $131.83 | $1,047.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $120.23 | Professional | None | $47.86 | $95.50 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $512.86 | Facility | None | $77.62 | $109.65 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $131.83 | Professional | None | $51.29 | $77.62 | $131.83 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $331.13 | Professional | None | $58.88 | $104.71 | $331.13 |
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 $48.98 Median $51.29 Typical High $97.72 | Professional | None | $48.98 | $51.29 | $97.72 |
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 $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 $45.71 Median $81.28 Typical High $144.54 | Professional | None | $45.71 | $81.28 | $144.54 |
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 $19.50 Median $29.51 Typical High $36.31 | Professional | 52 · Reduced service | $19.50 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $11.75 Typical High $14.45 | Professional | 53 · Discontinued | $7.76 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $44.67 Typical High $53.70 | Professional | 54 · Surgery only | $29.51 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $5.89 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.89 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.89 | $5.89 | $7.24 |
Where Illinois sits
The same service costs 3.5 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· 33rd of 51
$79.43
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.