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 $64.57 Median $104.71 Typical High $165.96 | Facility | None | $64.57 | $104.71 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $141.25 | Professional | None | $60.26 | $87.10 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $75.86 Typical High $123.03 | Professional | None | $21.38 | $75.86 | $123.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $107.15 Median $239.88 Typical High $794.33 | Facility | None | $107.15 | $239.88 | $794.33 |
BCBS Illinois Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $158.49 | Professional | None | $70.79 | $112.20 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $128.82 Typical High $223.87 | Facility | None | $70.79 | $128.82 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $147.91 | Professional | None | $63.10 | $85.11 | $147.91 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $269.15 | Professional | None | $75.86 | $123.03 | $269.15 |
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 $74.13 Median $79.43 Typical High $125.89 | Professional | None | $74.13 | $79.43 | $125.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $141.25 | Professional | None | $33.11 | $33.11 | $141.25 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $147.91 | Professional | None | $60.26 | $89.13 | $147.91 |
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 $30.20 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $30.20 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $12.02 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.22 Typical High $13.18 | Professional | 55 · Aftercare only | $9.12 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.03 | $7.41 | $8.91 |
Where Illinois sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 26th of 51
$100
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.