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 $46.77 Median $89.13 Typical High $295.12 | Facility | None | $46.77 | $89.13 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $109.65 Typical High $138.04 | Professional | None | $47.86 | $109.65 | $138.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $275.42 Median $363.08 Typical High $851.14 | Facility | None | $275.42 | $363.08 | $851.14 |
BCBS Illinois Setting Professional Modifier None Typical Low $57.54 Median $144.54 Typical High $257.04 | Professional | None | $57.54 | $144.54 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $407.38 Typical High $660.69 | Facility | None | $295.12 | $407.38 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $107.15 Typical High $194.98 | Professional | None | $45.71 | $107.15 | $194.98 |
Hally Health Setting Professional Modifier None Typical Low $51.29 Median $144.54 Typical High $346.74 | Professional | None | $51.29 | $144.54 | $346.74 |
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 $53.70 Median $54.95 Typical High $162.18 | Professional | None | $53.70 | $54.95 | $162.18 |
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 $501.19 Median $501.19 Typical High $575.44 | Facility | None | $501.19 | $501.19 | $575.44 |
United Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $213.80 | Professional | None | $45.71 | $102.33 | $213.80 |
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 $23.44 Median $41.69 Typical High $69.18 | Professional | 52 · Reduced service | $23.44 | $41.69 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $16.60 Typical High $27.54 | Professional | 53 · Discontinued | $9.55 | $16.60 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.30 Typical High $20.89 | Professional | 55 · Aftercare only | $7.08 | $12.30 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $8.13 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.79 | $8.13 | $13.80 |
Where Illinois sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 37th of 51
$105
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.