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 $40.74 Median $72.44 Typical High $131.83 | Facility | None | $40.74 | $72.44 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $114.82 | Professional | None | $39.81 | $66.07 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $95.50 | Professional | None | $50.12 | $53.70 | $95.50 |
BCBS Illinois Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $575.44 | Facility | None | $109.65 | $190.55 | $575.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $128.82 | Professional | None | $50.12 | $85.11 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $117.49 | Professional | None | $43.65 | $64.57 | $117.49 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $91.20 Typical High $208.93 | Professional | None | $52.48 | $91.20 | $208.93 |
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 $47.86 Median $50.12 Typical High $93.33 | Professional | None | $47.86 | $50.12 | $93.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $112.20 | Professional | None | $33.11 | $33.11 | $112.20 |
United Setting Facility Modifier None Typical Low $141.25 Median $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $109.65 | Professional | None | $40.74 | $64.57 | $109.65 |
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 $19.50 Median $28.18 Typical High $33.11 | Professional | 52 · Reduced service | $19.50 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $11.22 Typical High $13.18 | Professional | 53 · Discontinued | $7.76 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $5.89 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.89 | $5.62 | $6.61 |
Where Illinois sits
The same service costs 4.0 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· 28th of 51
$69.18
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.