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 $30.90 Median $51.29 Typical High $91.20 | Facility | None | $30.90 | $51.29 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $74.13 | Professional | None | $30.90 | $45.71 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $70.79 Typical High $93.33 | Professional | None | $45.71 | $70.79 | $93.33 |
BCBS Illinois Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $724.44 | Facility | None | $125.89 | $199.53 | $724.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $81.28 | Professional | None | $45.71 | $63.10 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $128.82 Typical High $158.49 | Facility | None | $120.23 | $128.82 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $109.65 | Professional | None | $47.86 | $64.57 | $109.65 |
Hally Health Setting Professional Modifier None Typical Low $51.29 Median $81.28 Typical High $147.91 | Professional | None | $51.29 | $81.28 | $147.91 |
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 $56.23 Median $81.28 Typical High $95.50 | Professional | None | $56.23 | $81.28 | $95.50 |
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 Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $120.23 | Professional | None | $48.98 | $72.44 | $120.23 |
8 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 Facility Modifier 52 · Reduced service Typical Low $16.98 Median $25.12 Typical High $32.36 | Facility | 52 · Reduced service | $16.98 | $25.12 | $32.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.13 Median $7.41 Typical High $9.55 | Facility | 55 · Aftercare only | $5.13 | $7.41 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.01 Typical High $6.46 | Facility | 56 · Pre-op care only | $3.39 | $5.01 | $6.46 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $25.12 Typical High $30.90 | Professional | 52 · Reduced service | $19.95 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.41 Typical High $9.33 | Professional | 55 · Aftercare only | $6.03 | $7.41 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.01 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.98 | $5.01 | $6.17 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 24 · Unrelated visit after surgery | $79.43 | $79.43 | $79.43 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $47.86 Median $72.44 Typical High $93.33 | Professional | 25 · Same-day visit | $47.86 | $72.44 | $93.33 |
Where Illinois sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 47th of 51
$53.70
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.