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 $67.61 Median $93.33 Typical High $251.19 | Facility | None | $67.61 | $93.33 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | None | $67.61 | $67.61 | $74.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $323.59 Median $416.87 Typical High $512.86 | Facility | None | $323.59 | $416.87 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $134.90 Typical High $162.18 | Facility | None | $91.20 | $134.90 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $223.87 | Professional | None | $74.13 | $87.10 | $223.87 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | None | $70.79 | $70.79 | $79.43 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $151.36 | Facility | None | $67.61 | $67.61 | $151.36 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | None | $67.61 | $67.61 | $72.44 |
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 $33.11 Median $33.11 Typical High $33.88 | Professional | 52 · Reduced service | $33.11 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Illinois sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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· 28th of 51
$72.44
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.