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 $75.86 Median $128.82 Typical High $208.93 | Facility | None | $75.86 | $128.82 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | None | $75.86 | $75.86 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $91.20 | Professional | None | $60.26 | $64.57 | $91.20 |
BCBS Illinois Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $602.56 | Facility | None | $162.18 | $257.04 | $602.56 |
BCBS Illinois Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | None | $79.43 | $79.43 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $162.18 Typical High $194.98 | Facility | None | $109.65 | $162.18 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Hally Health Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $151.36 | Professional | None | $72.44 | $102.33 | $151.36 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $208.93 | Facility | None | $81.28 | $81.28 | $208.93 |
United Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $89.13 | Professional | None | $72.44 | $87.10 | $89.13 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Illinois sits
The same service costs 2.8 times more in Alaska 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· 25th of 51
$81.28
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.