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 $42.66 Median $46.77 Typical High $117.49 | Facility | None | $42.66 | $46.77 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $47.86 | Professional | None | $42.66 | $46.77 | $47.86 |
BCBS Illinois Setting Facility Modifier None Typical Low $363.08 Median $524.81 Typical High $776.25 | Facility | None | $363.08 | $524.81 | $776.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $81.28 | Professional | None | $51.29 | $64.57 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $537.03 Typical High $1,513.56 | Facility | None | $380.19 | $537.03 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $85.11 | Professional | None | $51.29 | $66.07 | $85.11 |
Hally Health Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $912.01 | Professional | None | $48.98 | $77.62 | $912.01 |
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 $56.23 Median $58.88 Typical High $64.57 | Professional | None | $56.23 | $58.88 | $64.57 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $44.67 Median $63.10 Typical High $104.71 | Professional | None | $44.67 | $63.10 | $104.71 |
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 $21.38 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $21.38 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.33 Typical High $9.55 | Professional | 53 · Discontinued | $8.51 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.46 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.68 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.27 | $4.68 | $4.79 |
Where Illinois sits
The same service costs 4.7 times more in Wisconsin 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· 23rd of 51
$75.86
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.