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 $56.23 Median $56.23 Typical High $112.20 | Facility | None | $56.23 | $56.23 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $89.13 | Professional | None | $52.48 | $56.23 | $89.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $891.25 | Facility | None | $134.90 | $186.21 | $891.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | None | $63.10 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $151.36 | Professional | None | $87.10 | $109.65 | $151.36 |
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 $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | None | $83.18 | $83.18 | $91.20 |
United Setting Facility Modifier None Typical Low $56.23 Median $112.20 Typical High $141.25 | Facility | None | $56.23 | $112.20 | $141.25 |
United Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $128.82 | Professional | None | $40.74 | $54.95 | $128.82 |
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 $26.30 Median $28.18 Typical High $39.81 | Professional | 52 · Reduced service | $26.30 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.22 Typical High $15.85 | Professional | 53 · Discontinued | $10.47 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.51 Typical High $12.02 | Professional | 55 · Aftercare only | $7.94 | $8.51 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.62 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.25 | $5.62 | $7.94 |
Where Illinois sits
The same service costs 3.2 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
$72.44
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.