How much rates vary
Facilitymedian $135 · 10th to 90th $87 to $479Professionalmedian $135 · 10th to 90th $98 to $204
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 $85.11 Median $123.03 Typical High $208.93 | Facility | None | $85.11 | $123.03 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $173.78 | Professional | None | $85.11 | $114.82 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $213.80 | Professional | None | $120.23 | $169.82 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $128.82 Median $426.58 Typical High $1,862.09 | Facility | None | $128.82 | $426.58 | $1,862.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $194.98 | Professional | None | $128.82 | $151.36 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $134.90 Typical High $162.18 | Facility | None | $125.89 | $134.90 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $263.03 | Professional | None | $107.15 | $151.36 | $263.03 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $354.81 | Professional | None | $134.90 | $194.98 | $354.81 |
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 $158.49 Median $190.55 Typical High $223.87 | Professional | None | $158.49 | $190.55 | $223.87 |
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 Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $257.04 | Professional | None | $125.89 | $165.96 | $257.04 |
9 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 Facility Modifier 52 · Reduced service Typical Low $46.77 Median $57.54 Typical High $89.13 | Facility | 52 · Reduced service | $46.77 | $57.54 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $26.92 | Facility | 55 · Aftercare only | $14.13 | $17.38 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.48 Typical High $17.78 | Facility | 56 · Pre-op care only | $9.33 | $11.48 | $17.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $57.54 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $14.13 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $169.82 Typical High $208.93 | Professional | 25 · Same-day visit | $123.03 | $169.82 | $208.93 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $165.96 Median $223.87 Typical High $257.04 | Professional | 57 · Decision for surgery | $165.96 | $223.87 | $257.04 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $134.90 Median $154.88 Typical High $208.93 | Professional | GC · Resident with teaching physician | $134.90 | $154.88 | $208.93 |
Where Illinois sits
The same service costs 2.3 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· 42nd of 51
$135
AK $263AL $115
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.