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 $20.42 Median $933.25 Typical High $5,370.32 | Facility | None | $20.42 | $933.25 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $13.18 Typical High $28.18 | Professional | None | $12.59 | $13.18 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $16.22 Typical High $23.99 | Professional | None | $12.59 | $16.22 | $23.99 |
BCBS Illinois Setting Facility Modifier None Typical Low $75.86 Median $89.13 Typical High $309.03 | Facility | None | $75.86 | $89.13 | $309.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $19.50 Median $26.30 Typical High $30.20 | Professional | None | $19.50 | $26.30 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $741.31 Typical High $933.25 | Facility | None | $66.07 | $741.31 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $19.05 Typical High $28.18 | Professional | None | $15.49 | $19.05 | $28.18 |
Hally Health Setting Professional Modifier None Typical Low $15.49 Median $24.55 Typical High $77.62 | Professional | None | $15.49 | $24.55 | $77.62 |
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 $18.20 Median $18.62 Typical High $20.42 | Professional | None | $18.20 | $18.62 | $20.42 |
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 $138.04 Median $457.09 Typical High $1,819.70 | Facility | None | $138.04 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $12.88 Median $18.20 Typical High $28.84 | Professional | None | $12.88 | $18.20 | $28.84 |
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 $6.31 Median $6.61 Typical High $7.24 | Professional | 52 · Reduced service | $6.31 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.63 Typical High $2.88 | Professional | 53 · Discontinued | $2.51 | $2.63 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.55 Median $10.00 Typical High $10.72 | Professional | 54 · Surgery only | $9.55 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.00 Typical High $2.19 | Professional | 55 · Aftercare only | $1.91 | $2.00 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.32 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.26 | $1.32 | $1.45 |
Where Illinois sits
The same service costs 7.4 times more in Kansas than in Kentucky. 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· 20th of 51
$24.55
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.