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 $60.26 Median $60.26 Typical High $120.23 | Facility | None | $60.26 | $60.26 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $93.33 | Professional | None | $60.26 | $60.26 | $93.33 |
BCBS Illinois Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $812.83 | Facility | None | $144.54 | $194.98 | $812.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | None | $81.28 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $257.04 | Professional | None | $100.00 | $144.54 | $257.04 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | None | $67.61 | $67.61 | $97.72 |
United Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $190.55 | Facility | None | $77.62 | $120.23 | $190.55 |
United Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $141.25 | Professional | None | $52.48 | $58.88 | $141.25 |
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 $30.20 Median $30.20 Typical High $46.77 | Professional | 52 · Reduced service | $30.20 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $18.62 | Professional | 53 · Discontinued | $12.02 | $12.02 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $14.13 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $9.33 |
Where Illinois sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 20th of 51
$81.28
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.