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 $165.96 Median $281.84 Typical High $602.56 | Facility | None | $165.96 | $281.84 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | None | $165.96 | $165.96 | $190.55 |
BCBS Illinois Setting Facility Modifier None Typical Low $275.42 Median $575.44 Typical High $1,288.25 | Facility | None | $275.42 | $575.44 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $398.11 | Facility | None | $223.87 | $331.13 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $416.87 | Professional | None | $147.91 | $229.09 | $416.87 |
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 $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $371.54 | Facility | None | $165.96 | $165.96 | $371.54 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | None | $162.18 | $162.18 | $173.78 |
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 $83.18 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Where Illinois sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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
$170
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.