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 $165.96 Typical High $269.15 | Facility | None | $165.96 | $165.96 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $257.04 | Professional | None | $165.96 | $165.96 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $323.59 Median $389.05 Typical High $3,162.28 | Facility | None | $323.59 | $389.05 | $3,162.28 |
BCBS Illinois Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | None | $186.21 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $630.96 | Professional | None | $239.88 | $371.54 | $630.96 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $323.59 | Professional | None | $223.87 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $269.15 Median $588.84 Typical High $588.84 | Facility | None | $269.15 | $588.84 | $588.84 |
United Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $575.44 | Professional | None | $208.93 | $245.47 | $575.44 |
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 $83.18 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $21.88 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Where Illinois sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 48th of 51
$204
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.