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 $21.38 Median $1,202.26 Typical High $7,762.47 | Facility | None | $21.38 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $24.55 Typical High $61.66 | Professional | None | $21.38 | $24.55 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $20.89 | Professional | None | $16.60 | $20.89 | $20.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $467.74 | Facility | None | $169.82 | $190.55 | $467.74 |
BCBS Illinois Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $35.48 | Professional | None | $22.39 | $31.62 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $120.23 | Professional | None | $22.91 | $33.11 | $120.23 |
Hally Health Setting Professional Modifier None Typical Low $19.50 Median $30.90 Typical High $138.04 | Professional | None | $19.50 | $30.90 | $138.04 |
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 $22.91 Median $24.55 Typical High $26.92 | Professional | None | $22.91 | $24.55 | $26.92 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $141.25 Median $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $28.18 Median $53.70 Typical High $79.43 | Professional | None | $28.18 | $53.70 | $79.43 |
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 $9.77 Median $10.96 Typical High $12.02 | Professional | 52 · Reduced service | $9.77 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.37 Typical High $4.79 | Professional | 53 · Discontinued | $3.89 | $4.37 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $16.60 Typical High $18.20 | Professional | 54 · Surgery only | $14.45 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.31 Typical High $3.63 | Professional | 55 · Aftercare only | $2.88 | $3.31 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.19 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.95 | $2.19 | $2.45 |
Where Illinois sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 40th of 51
$32.36
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.