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 $47.86 Median $54.95 Typical High $114.82 | Facility | None | $47.86 | $54.95 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $85.11 | Professional | None | $47.86 | $58.88 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | None | $58.88 | $81.28 | $81.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $181.97 Median $346.74 Typical High $1,318.26 | Facility | None | $181.97 | $346.74 | $1,318.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $104.71 | Professional | None | $85.11 | $95.50 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $128.82 | Professional | None | $64.57 | $81.28 | $128.82 |
Hally Health Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $363.08 | Professional | None | $70.79 | $77.62 | $363.08 |
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 $64.57 Median $64.57 Typical High $67.61 | Professional | None | $64.57 | $64.57 | $67.61 |
United Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $144.54 | Professional | None | $72.44 | $89.13 | $144.54 |
3 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 $26.92 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $26.92 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.55 Typical High $11.75 | Professional | 55 · Aftercare only | $7.94 | $9.55 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.37 | $6.46 | $7.76 |
Where Illinois sits
The same service costs 2.1 times more in Oregon 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· 28th 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.