How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $9.55 Median $18.20 Typical High $42.66 | Facility | None | $9.55 | $18.20 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $16.98 Typical High $20.42 | Professional | None | $9.55 | $16.98 | $20.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $281.84 | Facility | None | $66.07 | $141.25 | $281.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $9.12 Median $19.95 Typical High $40.74 | Professional | None | $9.12 | $19.95 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $18.20 Typical High $29.51 | Professional | None | $9.33 | $18.20 | $29.51 |
Hally Health Setting Professional Modifier None Typical Low $11.75 Median $24.55 Typical High $60.26 | Professional | None | $11.75 | $24.55 | $60.26 |
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 $10.47 Median $10.72 Typical High $22.91 | Professional | None | $10.47 | $10.72 | $22.91 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $10.00 Median $17.78 Typical High $32.36 | Professional | None | $10.00 | $17.78 | $32.36 |
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 $4.79 Median $8.51 Typical High $10.00 | Professional | 52 · Reduced service | $4.79 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $3.39 Typical High $3.98 | Professional | 53 · Discontinued | $1.91 | $3.39 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $2.57 Typical High $2.95 | Professional | 55 · Aftercare only | $1.41 | $2.57 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.70 Typical High $2.00 | Professional | 56 · Pre-op care only | $0.95 | $1.70 | $2.00 |
Where Illinois sits
The same service costs 3.2 times more in Wisconsin than in Nebraska. 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· 23rd of 51
$19.05
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.