How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $25.12 Median $30.20 Typical High $54.95 | Facility | None | $25.12 | $30.20 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $51.29 | Professional | None | $25.12 | $30.20 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $147.91 Median $316.23 Typical High $630.96 | Facility | None | $147.91 | $316.23 | $630.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $43.65 | Professional | None | $25.70 | $25.70 | $43.65 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $109.65 | Professional | None | $52.48 | $61.66 | $109.65 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $23.44 Median $26.92 Typical High $66.07 | Professional | None | $23.44 | $26.92 | $66.07 |
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 $12.59 Median $15.14 Typical High $22.91 | Professional | 52 · Reduced service | $12.59 | $15.14 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.03 Typical High $9.33 | Professional | 53 · Discontinued | $5.01 | $6.03 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.57 Typical High $6.92 | Professional | 55 · Aftercare only | $3.80 | $4.57 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.02 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.51 | $3.02 | $4.68 |
Where Illinois sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 19th of 51
$41.69
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.