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 $144.54 Median $204.17 Typical High $204.17 | Facility | None | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | None | $144.54 | $144.54 | $208.93 |
BCBS Illinois Setting Facility Modifier None Typical Low $239.88 Median $457.09 Typical High $1,862.09 | Facility | None | $239.88 | $457.09 | $1,862.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | None | $169.82 | $169.82 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $316.23 Typical High $380.19 | Facility | None | $213.80 | $316.23 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Hally Health Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $199.53 | Professional | None | $14.79 | $21.38 | $199.53 |
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 $17.38 Median $17.78 Typical High $19.05 | Professional | None | $17.38 | $17.78 | $19.05 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $141.25 | Professional | None | $107.15 | $131.83 | $141.25 |
United Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $169.82 | Professional | None | $138.04 | $165.96 | $169.82 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Where Illinois sits
The same service costs 1.9 times more in Arizona than in New Mexico. 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· 4th of 51
$170
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.