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 $32.36 Median $45.71 Typical High $45.71 | Facility | None | $32.36 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $48.98 | Professional | None | $32.36 | $32.36 | $48.98 |
BCBS Illinois Setting Facility Modifier None Typical Low $63.10 Median $123.03 Typical High $467.74 | Facility | None | $63.10 | $123.03 | $467.74 |
BCBS Illinois Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | None | $36.31 | $36.31 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $69.18 Typical High $83.18 | Facility | None | $46.77 | $69.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Hally Health Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $75.86 | Professional | None | $30.20 | $44.67 | $75.86 |
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 $38.90 Median $38.90 Typical High $42.66 | Professional | None | $38.90 | $38.90 | $42.66 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $31.62 | Professional | None | $17.38 | $17.38 | $31.62 |
United Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $37.15 | Professional | None | $30.90 | $37.15 | $37.15 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where Illinois sits
The same service costs 5.4 times more in Arizona than in Rhode Island. 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· 11th of 51
$36.31
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.