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 $97.72 Median $165.96 Typical High $346.74 | Facility | None | $97.72 | $165.96 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $138.04 | Professional | None | $67.61 | $93.33 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | None | $48.98 | $48.98 | $70.79 |
BCBS Illinois Setting Facility Modifier None Typical Low $19.05 Median $70.79 Typical High $165.96 | Facility | None | $19.05 | $70.79 | $165.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $3.47 Median $74.13 Typical High $74.13 | Professional | None | $3.47 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $234.42 Typical High $478.63 | Facility | None | $123.03 | $234.42 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $151.36 | Professional | None | $60.26 | $60.26 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $288.40 | Professional | None | $114.82 | $158.49 | $288.40 |
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 $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $144.54 | Professional | None | $81.28 | $81.28 | $144.54 |
United Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $144.54 | Facility | None | $114.82 | $138.04 | $144.54 |
United Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $120.23 | Professional | None | $40.74 | $47.86 | $120.23 |
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 $46.77 Median $46.77 Typical High $57.54 | Professional | 52 · Reduced service | $46.77 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $22.91 | Professional | 53 · Discontinued | $18.62 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 54 · Surgery only | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $11.48 |
Where Illinois sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 45th of 51
$74.13
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.