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 $371.54 Median $371.54 Typical High $776.25 | Facility | None | $371.54 | $371.54 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $616.60 | Professional | None | $371.54 | $371.54 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $5,248.07 | Facility | None | $933.25 | $1,258.93 | $5,248.07 |
BCBS Illinois Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $977.24 | Professional | None | $630.96 | $758.58 | $977.24 |
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 $363.08 Median $1,023.29 Typical High $1,023.29 | Facility | None | $363.08 | $1,023.29 | $1,023.29 |
United Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $891.25 | Professional | None | $316.23 | $380.19 | $891.25 |
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 $186.21 Typical High $309.03 | Professional | 52 · Reduced service | $186.21 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | 53 · Discontinued | $74.13 | $74.13 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $93.33 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $61.66 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $61.66 |
Where Illinois sits
The same service costs 2.8 times more in Hawaii than in Delaware. 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· 13th of 51
$589
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.