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 $53.70 Median $269.15 Typical High $5,128.61 | Facility | None | $53.70 | $269.15 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $173.78 Typical High $257.04 | Professional | None | $44.67 | $173.78 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $79.43 | Professional | None | $34.67 | $34.67 | $79.43 |
BCBS Illinois Setting Facility Modifier None Typical Low $323.59 Median $691.83 Typical High $1,380.38 | Facility | None | $323.59 | $691.83 | $1,380.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $50.12 Median $208.93 Typical High $407.38 | Professional | None | $50.12 | $208.93 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $134.90 Typical High $316.23 | Professional | None | $47.86 | $134.90 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $281.84 Typical High $602.56 | Professional | None | $58.88 | $281.84 | $602.56 |
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 $51.29 Median $53.70 Typical High $263.03 | Professional | None | $51.29 | $53.70 | $263.03 |
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 Facility Modifier None Typical Low $173.78 Median $1,000.00 Typical High $3,235.94 | Facility | None | $173.78 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $47.86 Median $181.97 Typical High $371.54 | Professional | None | $47.86 | $181.97 | $371.54 |
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 $21.88 Median $81.28 Typical High $104.71 | Professional | 52 · Reduced service | $21.88 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $32.36 Typical High $42.66 | Professional | 53 · Discontinued | $8.91 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $24.55 Typical High $31.62 | Professional | 55 · Aftercare only | $6.61 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $4.47 | $16.22 | $20.89 |
Where Illinois sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 17th of 51
$195
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.