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 $112.20 Median $1,318.26 Typical High $5,623.41 | Facility | None | $112.20 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $120.23 | Professional | None | $70.79 | $104.71 | $120.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $380.19 Median $812.83 Typical High $1,621.81 | Facility | None | $380.19 | $812.83 | $1,621.81 |
BCBS Illinois Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $208.93 | Professional | None | $74.13 | $123.03 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $190.55 | Professional | None | $77.62 | $117.49 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $346.74 | Professional | None | $93.33 | $162.18 | $346.74 |
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 |
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 $851.14 Median $2,884.03 Typical High $12,589.25 | Facility | None | $851.14 | $2,884.03 | $12,589.25 |
United Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $223.87 | Professional | None | $81.28 | $134.90 | $223.87 |
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 $35.48 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $20.42 Typical High $22.39 | Professional | 53 · Discontinued | $14.13 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.23 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.08 | $10.23 | $11.22 |
Where Illinois sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 35th of 51
$135
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.