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 $3.02 Median $3.02 Typical High $39.81 | Facility | None | $3.02 | $3.02 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $20.89 | Professional | None | $3.02 | $3.02 | $20.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $26.30 Median $93.33 Typical High $147.91 | Facility | None | $26.30 | $93.33 | $147.91 |
BCBS Illinois Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | None | $15.14 | $15.14 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $17.38 Typical High $37.15 | Professional | None | $15.49 | $17.38 | $37.15 |
Hally Health Setting Professional Modifier None Typical Low $16.98 Median $22.91 Typical High $40.74 | Professional | None | $16.98 | $22.91 | $40.74 |
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 |
Hally Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | None | $19.95 | $19.95 | $21.88 |
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 $169.82 Median $169.82 Typical High $194.98 | Facility | None | $169.82 | $169.82 | $194.98 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $26.30 | Professional | None | $10.96 | $16.60 | $26.30 |
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 $1.51 Median $1.51 Typical High $2.19 | Professional | 52 · Reduced service | $1.51 | $1.51 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.87 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.65 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.44 |
Where Illinois sits
The same service costs 5.2 times more in Texas 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· 33rd of 51
$16.98
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.