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 $478.63 Median $537.03 Typical High $1,995.26 | Facility | None | $478.63 | $537.03 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $676.08 | Professional | None | $537.03 | $537.03 | $676.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $4,265.80 | Facility | None | $1,318.26 | $2,187.76 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,288.25 | Facility | None | $724.44 | $1,071.52 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $478.63 Median $1,174.90 Typical High $1,548.82 | Professional | None | $478.63 | $1,174.90 | $1,548.82 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $562.34 | Professional | None | $549.54 | $549.54 | $562.34 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $1,202.26 | Facility | None | $537.03 | $537.03 | $1,202.26 |
United Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
5 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 $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | JZ · No drug discarded | $446.68 | $446.68 | $446.68 |
Where Illinois sits
The same service costs 5.0 times more in Wyoming than in Alabama. 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· 23rd of 51
$550
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.