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 $22.39 Median $48.98 Typical High $125.89 | Facility | None | $22.39 | $48.98 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $48.98 Typical High $58.88 | Professional | None | $25.12 | $48.98 | $58.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $562.34 | Facility | None | $75.86 | $91.20 | $562.34 |
BCBS Illinois Setting Professional Modifier None Typical Low $30.20 Median $58.88 Typical High $100.00 | Professional | None | $30.20 | $58.88 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $56.23 Typical High $85.11 | Professional | None | $30.20 | $56.23 | $85.11 |
Hally Health Setting Professional Modifier None Typical Low $35.48 Median $75.86 Typical High $154.88 | Professional | None | $35.48 | $75.86 | $154.88 |
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 $29.51 Median $32.36 Typical High $75.86 | Professional | None | $29.51 | $32.36 | $75.86 |
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 $138.04 Median $457.09 Typical High $1,819.70 | Facility | None | $138.04 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $100.00 | Professional | None | $30.90 | $53.70 | $100.00 |
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 $12.02 Median $23.44 Typical High $28.18 | Professional | 52 · Reduced service | $12.02 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $9.33 Typical High $11.22 | Professional | 53 · Discontinued | $4.79 | $9.33 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $7.08 Typical High $8.51 | Professional | 55 · Aftercare only | $3.63 | $7.08 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $4.68 Typical High $5.62 | Professional | 56 · Pre-op care only | $2.40 | $4.68 | $5.62 |
Where Illinois sits
The same service costs 3.5 times more in Wisconsin than in Utah. 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· 28th of 51
$56.23
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.