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 $63.10 Median $64.57 Typical High $125.89 | Facility | None | $63.10 | $64.57 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $100.00 | Professional | None | $63.10 | $63.10 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $851.14 | Facility | None | $151.36 | $213.80 | $851.14 |
BCBS Illinois Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | None | $74.13 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $173.78 | Professional | None | $100.00 | $123.03 | $173.78 |
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 $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $138.04 | Professional | None | $104.71 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $181.97 | Facility | None | $72.44 | $125.89 | $181.97 |
United Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $144.54 | Professional | None | $50.12 | $61.66 | $144.54 |
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 $31.62 Median $31.62 Typical High $45.71 | Professional | 52 · Reduced service | $31.62 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $18.20 | Professional | 53 · Discontinued | $12.88 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $13.49 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $9.12 |
Where Illinois sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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
$89.13
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.