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 $144.54 Median $1,862.09 Typical High $7,762.47 | Facility | None | $144.54 | $1,862.09 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $213.80 | Professional | None | $128.82 | $144.54 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $263.03 Median $346.74 Typical High $1,548.82 | Facility | None | $263.03 | $346.74 | $1,548.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | None | $141.25 | $141.25 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $616.60 | Facility | None | $257.04 | $389.05 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $234.42 | Professional | None | $141.25 | $190.55 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $302.00 | Professional | None | $128.82 | $173.78 | $302.00 |
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 $151.36 Median $158.49 Typical High $169.82 | Professional | None | $151.36 | $158.49 | $169.82 |
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 $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $275.42 | Professional | None | $120.23 | $151.36 | $275.42 |
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 $64.57 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $64.57 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $25.70 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.50 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.88 | $14.45 | $14.45 |
Where Illinois sits
The same service costs 3.2 times more in Alaska 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
$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.