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 $102.33 Median $104.71 Typical High $107.15 | Facility | None | $102.33 | $104.71 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $120.23 | Professional | None | $87.10 | $104.71 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | None | $102.33 | $114.82 | $114.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $239.88 Median $457.09 Typical High $1,819.70 | Facility | None | $239.88 | $457.09 | $1,819.70 |
BCBS Illinois Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $208.93 | Professional | None | $117.49 | $134.90 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $144.54 | Professional | None | $83.18 | $102.33 | $144.54 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $190.55 | Professional | None | $97.72 | $109.65 | $190.55 |
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 $89.13 Median $91.20 Typical High $95.50 | Professional | None | $89.13 | $91.20 | $95.50 |
United Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $190.55 | Professional | None | $93.33 | $114.82 | $190.55 |
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 $43.65 Median $52.48 Typical High $53.70 | Professional | 52 · Reduced service | $43.65 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.89 Typical High $21.38 | Professional | 53 · Discontinued | $17.38 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $16.22 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.47 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.71 | $10.47 | $10.72 |
Where Illinois sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 22nd of 51
$117
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.