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 $134.90 Median $1,148.15 Typical High $5,623.41 | Facility | None | $134.90 | $1,148.15 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $234.42 | Professional | None | $107.15 | $147.91 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $363.08 | Professional | None | $144.54 | $144.54 | $363.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $181.97 Median $288.40 Typical High $1,513.56 | Facility | None | $181.97 | $288.40 | $1,513.56 |
BCBS Illinois Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $354.81 | Professional | None | $138.04 | $213.80 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $234.42 Typical High $676.08 | Facility | None | $158.49 | $234.42 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $316.23 | Professional | None | $138.04 | $190.55 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $501.19 | Professional | None | $151.36 | $245.47 | $501.19 |
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 $134.90 Median $147.91 Typical High $245.47 | Professional | None | $134.90 | $147.91 | $245.47 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $281.84 | Professional | None | $33.11 | $33.11 | $281.84 |
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 $123.03 Median $177.83 Typical High $302.00 | Professional | None | $123.03 | $177.83 | $302.00 |
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 $52.48 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $52.48 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.18 Typical High $35.48 | Professional | 53 · Discontinued | $21.38 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $131.83 | Professional | 54 · Surgery only | $79.43 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.38 Typical High $26.30 | Professional | 55 · Aftercare only | $15.85 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.47 | $14.13 | $17.78 |
Where Illinois sits
The same service costs 3.3 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
$182
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.