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 $131.83 Median $131.83 Typical High $229.09 | Facility | None | $131.83 | $131.83 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | None | $131.83 | $131.83 | $186.21 |
BCBS Illinois Setting Facility Modifier None Typical Low $309.03 Median $549.54 Typical High $2,089.30 | Facility | None | $309.03 | $549.54 | $2,089.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | None | $154.88 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $426.58 | Professional | None | $204.17 | $288.40 | $426.58 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | None | $190.55 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $489.78 | Facility | None | $213.80 | $234.42 | $489.78 |
United Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $407.38 | Professional | None | $147.91 | $169.82 | $407.38 |
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 $66.07 Median $66.07 Typical High $91.20 | Professional | 52 · Reduced service | $66.07 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $37.15 | Professional | 53 · Discontinued | $26.30 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $18.62 |
Where Illinois sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 39th of 51
$174
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.