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 $81.28 Median $107.15 Typical High $229.09 | Facility | None | $81.28 | $107.15 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $141.25 | Professional | None | $81.28 | $97.72 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | None | $112.20 | $141.25 | $141.25 |
BCBS Setting Facility Modifier None Typical Low $263.03 Median $524.81 Typical High $2,137.96 | Facility | None | $263.03 | $524.81 | $2,137.96 |
BCBS Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $177.83 | Professional | None | $144.54 | $162.18 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $208.93 | Professional | None | $104.71 | $125.89 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $263.03 | Professional | None | $117.49 | $144.54 | $263.03 |
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 $107.15 Median $109.65 Typical High $114.82 | Professional | None | $107.15 | $109.65 | $114.82 |
United Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $223.87 | Professional | None | $109.65 | $131.83 | $223.87 |
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 $44.67 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $44.67 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.91 | $10.72 | $12.30 |
Where Illinois sits
The same service costs 2.1 times more in Wisconsin than in Ohio. 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· 16th of 51
$145
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.