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 $97.72 Median $97.72 Typical High $194.98 | Facility | None | $97.72 | $97.72 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $141.25 | Professional | None | $89.13 | $97.72 | $141.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $229.09 Median $316.23 Typical High $1,318.26 | Facility | None | $229.09 | $316.23 | $1,318.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $147.91 | Professional | None | $95.50 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $245.47 | Professional | None | $151.36 | $190.55 | $245.47 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
United Setting Facility Modifier None Typical Low $93.33 Median $194.98 Typical High $245.47 | Facility | None | $93.33 | $194.98 | $245.47 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $223.87 | Professional | None | $69.18 | $95.50 | $223.87 |
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 $45.71 Median $48.98 Typical High $69.18 | Professional | 52 · Reduced service | $45.71 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $27.54 | Professional | 53 · Discontinued | $18.20 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $20.89 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $13.80 |
Where Illinois sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 17th of 51
$126
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.