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 $501.19 Median $501.19 Typical High $776.25 | Facility | None | $501.19 | $501.19 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $794.33 | Professional | None | $501.19 | $501.19 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $10,000.00 | Facility | None | $933.25 | $1,148.15 | $10,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | None | $537.03 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $812.83 | Professional | None | $588.84 | $588.84 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,905.46 | Professional | None | $691.83 | $1,071.52 | $1,905.46 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $645.65 | Professional | None | $269.15 | $269.15 | $645.65 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,737.80 Typical High $1,737.80 | Facility | None | $776.25 | $1,737.80 | $1,737.80 |
United Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,819.70 | Professional | None | $588.84 | $776.25 | $1,819.70 |
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 $251.19 Median $251.19 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $63.10 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | RR · Rental | $69.18 | $69.18 | $81.28 |
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· 43rd of 51
$589
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.