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 $38.02 Median $1,202.26 Typical High $7,762.47 | Facility | None | $38.02 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $61.66 | Professional | None | $33.88 | $40.74 | $61.66 |
BCBS Illinois Setting Facility Modifier None Typical Low $380.19 Median $645.65 Typical High $831.76 | Facility | None | $380.19 | $645.65 | $831.76 |
BCBS Illinois Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $75.86 | Professional | None | $34.67 | $50.12 | $75.86 |
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 $32.36 Median $51.29 Typical High $67.61 | Professional | None | $32.36 | $51.29 | $67.61 |
Hally Health Setting Professional Modifier None Typical Low $34.67 Median $57.54 Typical High $173.78 | Professional | None | $34.67 | $57.54 | $173.78 |
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 $40.74 Median $41.69 Typical High $54.95 | Professional | None | $40.74 | $41.69 | $54.95 |
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 $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $89.13 | Professional | None | $35.48 | $46.77 | $89.13 |
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 $16.98 Median $20.42 Typical High $22.91 | Professional | 52 · Reduced service | $16.98 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.32 Typical High $9.12 | Professional | 53 · Discontinued | $6.76 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $30.90 Typical High $34.67 | Professional | 54 · Surgery only | $25.12 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.17 Typical High $6.92 | Professional | 55 · Aftercare only | $5.13 | $6.17 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.07 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.39 | $4.07 | $4.57 |
Where Illinois sits
The same service costs 3.8 times more in Alaska than in Utah. 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
$50.12
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.