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 $24.55 Median $63.10 Typical High $89.13 | Facility | None | $24.55 | $63.10 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $61.66 Typical High $89.13 | Professional | None | $26.92 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $30.90 Typical High $43.65 | Professional | 52 · Reduced service | $13.49 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $12.30 Typical High $17.78 | Professional | 53 · Discontinued | $5.37 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $9.33 Typical High $13.18 | Professional | 55 · Aftercare only | $3.98 | $9.33 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $6.17 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.69 | $6.17 | $8.71 |
BCBS Illinois Setting Facility Modifier None Typical Low $165.96 Median $208.93 Typical High $524.81 | Facility | None | $165.96 | $208.93 | $524.81 |
BCBS Illinois Setting Professional Modifier None Typical Low $28.84 Median $97.72 Typical High $138.04 | Professional | None | $28.84 | $97.72 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $120.23 | Professional | None | $37.15 | $64.57 | $120.23 |
Hally Health Setting Professional Modifier None Typical Low $23.44 Median $72.44 Typical High $190.55 | Professional | None | $23.44 | $72.44 | $190.55 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $354.81 | Facility | None | $316.23 | $316.23 | $354.81 |
United Setting Professional Modifier None Typical Low $29.51 Median $46.77 Typical High $109.65 | Professional | None | $29.51 | $46.77 | $109.65 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Illinois sits
The same service costs 3.5 times more in Hawaii than in Maryland. 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· 27th of 51
$63.10
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.