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 $114.82 Median $141.25 Typical High $213.80 | Professional | None | $114.82 | $141.25 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $1,513.56 | Facility | None | $144.54 | $234.42 | $1,513.56 |
BCBS Illinois Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $323.59 | Professional | None | $141.25 | $208.93 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $190.55 Typical High $676.08 | Facility | None | $128.82 | $190.55 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $288.40 | Professional | None | $134.90 | $186.21 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $467.74 | Professional | None | $151.36 | $234.42 | $467.74 |
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 $131.83 Median $151.36 Typical High $229.09 | Professional | None | $131.83 | $151.36 | $229.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $257.04 | Professional | None | $33.11 | $33.11 | $257.04 |
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 $165.96 Typical High $281.84 | Professional | None | $123.03 | $165.96 | $281.84 |
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 $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $52.48 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.30 Typical High $32.36 | Professional | 53 · Discontinued | $20.89 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $100.00 Typical High $123.03 | Professional | 54 · Surgery only | $77.62 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $24.55 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.47 | $13.18 | $16.22 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$178
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.