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 $95.50 Median $131.83 Typical High $190.55 | Facility | None | $95.50 | $131.83 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $162.18 | Professional | None | $83.18 | $109.65 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,548.82 Median $3,235.94 Typical High $4,677.35 | Facility | None | $1,548.82 | $3,235.94 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $173.78 | Professional | None | $128.82 | $158.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $3,019.95 Typical High $3,890.45 | Facility | None | $489.78 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $213.80 | Professional | None | $114.82 | $134.90 | $213.80 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $549.54 | Professional | None | $114.82 | $165.96 | $549.54 |
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 $114.82 Median $134.90 Typical High $154.88 | Professional | None | $114.82 | $134.90 | $154.88 |
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 $1,047.13 Median $2,398.83 Typical High $7,079.46 | Facility | None | $1,047.13 | $2,398.83 | $7,079.46 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $239.88 | Professional | None | $97.72 | $141.25 | $239.88 |
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 $39.81 Median $53.70 Typical High $57.54 | Professional | 52 · Reduced service | $39.81 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $21.88 Typical High $22.91 | Professional | 53 · Discontinued | $15.85 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $12.02 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.96 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $10.96 | $11.48 |
Where Illinois sits
The same service costs 7.9 times more in Kansas than in New York. 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· 26th of 51
$158
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.