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 $1,479.11 Median $1,479.11 Typical High $3,019.95 | Facility | None | $1,479.11 | $1,479.11 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,479.11 | $2,398.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,630.78 Median $5,011.87 Typical High $20,417.38 | Facility | None | $3,630.78 | $5,011.87 | $20,417.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,344.23 | $2,951.21 | $3,715.35 |
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 $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,454.71 | Professional | None | $2,398.83 | $2,398.83 | $2,454.71 |
United Setting Facility Modifier None Typical Low $870.96 Median $3,019.95 Typical High $3,715.35 | Facility | None | $870.96 | $3,019.95 | $3,715.35 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,047.13 | $1,479.11 | $3,467.37 |
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 $724.44 Median $724.44 Typical High $1,202.26 | Professional | 52 · Reduced service | $724.44 | $724.44 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $478.63 | Professional | 53 · Discontinued | $295.12 | $295.12 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $363.08 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $239.88 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $239.88 |
Where Illinois sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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· 10th of 51
$2,291
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.