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 $138.04 Median $181.97 Typical High $218.78 | Facility | None | $138.04 | $181.97 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $245.47 | Professional | None | $138.04 | $181.97 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $281.84 | Professional | None | $173.78 | $204.17 | $281.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $467.74 Median $741.31 Typical High $2,398.83 | Facility | None | $467.74 | $741.31 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $316.23 | Professional | None | $181.97 | $239.88 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $630.96 | Professional | None | $190.55 | $251.19 | $630.96 |
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 $218.78 Median $223.87 Typical High $275.42 | Professional | None | $218.78 | $223.87 | $275.42 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | None | $91.20 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $371.54 | Professional | None | $186.21 | $234.42 | $371.54 |
6 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 $93.33 Median $107.15 Typical High $131.83 | Facility | 52 · Reduced service | $93.33 | $107.15 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $39.81 | Facility | 55 · Aftercare only | $27.54 | $32.36 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $26.30 | Facility | 56 · Pre-op care only | $18.62 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $93.33 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $21.88 |
Where Illinois sits
The same service costs 2.4 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· 30th of 51
$204
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.