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 $20.42 Median $1,202.26 Typical High $7,762.47 | Facility | None | $20.42 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $46.77 Typical High $79.43 | Professional | None | $20.42 | $46.77 | $79.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $20.89 Typical High $39.81 | Professional | 52 · Reduced service | $10.23 | $20.89 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $8.51 Typical High $15.85 | Professional | 53 · Discontinued | $4.07 | $8.51 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $6.31 Typical High $12.02 | Professional | 55 · Aftercare only | $3.09 | $6.31 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $4.27 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.04 | $4.27 | $7.94 |
BCBS Illinois Setting Facility Modifier None Typical Low $104.71 Median $245.47 Typical High $371.54 | Facility | None | $104.71 | $245.47 | $371.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $21.38 Median $69.18 Typical High $109.65 | Professional | None | $21.38 | $69.18 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Hally Health Setting Professional Modifier None Typical Low $20.42 Median $75.86 Typical High $173.78 | Professional | None | $20.42 | $75.86 | $173.78 |
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 $26.30 Median $26.92 Typical High $107.15 | Professional | None | $26.30 | $26.92 | $107.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $537.03 | Facility | None | $478.63 | $478.63 | $537.03 |
United Setting Professional Modifier None Typical Low $22.91 Median $44.67 Typical High $131.83 | Professional | None | $22.91 | $44.67 | $131.83 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $38.90 Median $38.90 Typical High $50.12 | Professional | 59 · Distinct service | $38.90 | $38.90 | $50.12 |
Where Illinois sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 43rd of 51
$46.77
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.