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 $151.36 Median $151.36 Typical High $302.00 | Facility | None | $151.36 | $151.36 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $239.88 | Professional | None | $151.36 | $151.36 | $239.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $2,041.74 | Facility | None | $363.08 | $501.19 | $2,041.74 |
BCBS Illinois Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | None | $199.53 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $436.52 | Professional | None | $234.42 | $323.59 | $436.52 |
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 $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | None | $223.87 | $223.87 | $245.47 |
United Setting Facility Modifier None Typical Low $190.55 Median $302.00 Typical High $478.63 | Facility | None | $190.55 | $302.00 | $478.63 |
United Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $354.81 | Professional | None | $131.83 | $147.91 | $354.81 |
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 $75.86 Median $75.86 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $23.44 |
Where Illinois sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 21st of 51
$214
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.