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 $199.53 Median $3,019.95 Typical High $9,120.11 | Facility | None | $199.53 | $3,019.95 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $323.59 | Professional | None | $112.20 | $199.53 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $2,570.40 | Facility | None | $223.87 | $346.74 | $2,570.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $416.87 | Professional | None | $134.90 | $263.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $1,096.48 | Facility | None | $208.93 | $295.12 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $288.40 Typical High $794.33 | Professional | None | $138.04 | $288.40 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $933.25 | Professional | None | $165.96 | $323.59 | $933.25 |
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 $147.91 Median $158.49 Typical High $302.00 | Professional | None | $147.91 | $158.49 | $302.00 |
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 $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $724.44 | Professional | None | $138.04 | $239.88 | $724.44 |
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 $54.95 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $54.95 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.90 Typical High $39.81 | Professional | 53 · Discontinued | $22.39 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $144.54 Typical High $151.36 | Professional | 54 · Surgery only | $83.18 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $16.60 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.50 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.22 | $19.50 | $19.95 |
Where Illinois sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 30th of 51
$263
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.