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 $15.14 Median $38.90 Typical High $93.33 | Facility | None | $15.14 | $38.90 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $58.88 Typical High $77.62 | Professional | None | $15.14 | $58.88 | $77.62 |
BCBS Illinois Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $281.84 | Facility | None | $95.50 | $141.25 | $281.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $15.49 Median $64.57 Typical High $141.25 | Professional | None | $15.49 | $64.57 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $123.03 Typical High $501.19 | Facility | None | $70.79 | $123.03 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $64.57 Typical High $107.15 | Professional | None | $16.98 | $64.57 | $107.15 |
Hally Health Setting Professional Modifier None Typical Low $21.88 Median $104.71 Typical High $257.04 | Professional | None | $21.88 | $104.71 | $257.04 |
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 $19.50 Median $19.50 Typical High $100.00 | Professional | None | $19.50 | $19.50 | $100.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $102.33 | Professional | None | $33.11 | $33.11 | $102.33 |
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 $15.85 Median $58.88 Typical High $138.04 | Professional | None | $15.85 | $58.88 | $138.04 |
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 $7.59 Median $29.51 Typical High $38.90 | Professional | 52 · Reduced service | $7.59 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $11.75 Typical High $15.49 | Professional | 53 · Discontinued | $3.02 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $9.12 Typical High $11.75 | Professional | 55 · Aftercare only | $2.24 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $5.89 Typical High $7.76 | Professional | 56 · Pre-op care only | $1.51 | $5.89 | $7.76 |
Where Illinois sits
The same service costs 5.9 times more in Iowa 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· 27th of 51
$70.79
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.