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 $67.61 Typical High $131.83 | Facility | None | $67.61 | $67.61 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $95.50 | Professional | None | $64.57 | $67.61 | $95.50 |
BCBS Illinois Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $891.25 | Facility | None | $158.49 | $218.78 | $891.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | None | $79.43 | $102.33 | $102.33 |
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 $107.15 Median $131.83 Typical High $169.82 | Professional | None | $107.15 | $131.83 | $169.82 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | None | $97.72 | $97.72 | $109.65 |
United Setting Facility Modifier None Typical Low $69.18 Median $131.83 Typical High $177.83 | Facility | None | $69.18 | $131.83 | $177.83 |
United Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $151.36 | Professional | None | $50.12 | $64.57 | $151.36 |
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 $32.36 Median $33.88 Typical High $47.86 | Professional | 52 · Reduced service | $32.36 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $19.05 | Professional | 53 · Discontinued | $12.88 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $14.45 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $9.55 |
Where Illinois sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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· 19th of 51
$83.18
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.