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 $2,041.74 Median $2,041.74 Typical High $4,168.69 | Facility | None | $2,041.74 | $2,041.74 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,041.74 | $3,388.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,011.87 Median $6,918.31 Typical High $28,183.83 | Facility | None | $5,011.87 | $6,918.31 | $28,183.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,168.69 Typical High $5,495.41 | Professional | None | $3,467.37 | $4,168.69 | $5,495.41 |
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 $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,467.37 | Professional | None | $3,311.31 | $3,311.31 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $5,623.41 Typical High $5,623.41 | Facility | None | $1,949.84 | $5,623.41 | $5,623.41 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $4,786.30 | Professional | None | $1,737.80 | $2,041.74 | $4,786.30 |
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 $1,023.29 Median $1,023.29 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $676.08 | Professional | 53 · Discontinued | $407.38 | $407.38 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $501.19 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $338.84 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $338.84 |
Where Illinois sits
The same service costs 2.6 times more in Wisconsin 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· 14th of 51
$3,162
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.