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 $338.84 Median $371.54 Typical High $467.74 | Facility | None | $338.84 | $371.54 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $537.03 | Professional | None | $338.84 | $338.84 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $575.44 | Professional | None | $138.04 | $177.83 | $575.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $5,370.32 | Facility | None | $1,230.27 | $2,630.27 | $5,370.32 |
BCBS Illinois Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $741.31 Typical High $891.25 | Facility | None | $501.19 | $741.31 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $398.11 Typical High $549.54 | Professional | None | $151.36 | $398.11 | $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 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $331.13 | Professional | None | $30.20 | $30.20 | $331.13 |
United Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | None | $331.13 | $398.11 | $398.11 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Illinois sits
The same service costs 3.0 times more in Arizona than in Alabama. 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
$398
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.