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 $380.19 Median $380.19 Typical High $758.58 | Facility | None | $380.19 | $380.19 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $380.19 Typical High $602.56 | Professional | None | $371.54 | $380.19 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | None | $478.63 | $575.44 | $575.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $5,128.61 | Facility | None | $912.01 | $1,258.93 | $5,128.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $575.44 | Professional | None | $389.05 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,047.13 | Professional | None | $602.56 | $741.31 | $1,047.13 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | None | $602.56 | $602.56 | $630.96 |
United Setting Facility Modifier None Typical Low $389.05 Median $758.58 Typical High $1,023.29 | Facility | None | $389.05 | $758.58 | $1,023.29 |
United Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $870.96 | Professional | None | $281.84 | $371.54 | $870.96 |
4 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 $186.21 Median $190.55 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $190.55 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $81.28 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.02 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $38.02 | $54.95 |
Where Illinois sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 15th of 51
$525
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.