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 $45.71 Median $66.07 Typical High $91.20 | Facility | None | $45.71 | $66.07 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $74.13 | Professional | None | $45.71 | $46.77 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $123.03 | Professional | None | $61.66 | $69.18 | $123.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $616.60 | Facility | None | $109.65 | $151.36 | $616.60 |
BCBS Illinois Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | None | $63.10 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $147.91 | Professional | None | $75.86 | $93.33 | $147.91 |
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 $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $75.86 | Professional | None | $36.31 | $36.31 | $75.86 |
United Setting Facility Modifier None Typical Low $43.65 Median $91.20 Typical High $147.91 | Facility | None | $43.65 | $91.20 | $147.91 |
United Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $109.65 | Professional | None | $40.74 | $44.67 | $109.65 |
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 $22.91 Median $22.91 Typical High $36.31 | Professional | 52 · Reduced service | $22.91 | $22.91 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $14.79 | Professional | 53 · Discontinued | $9.33 | $9.33 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $10.96 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $7.41 |
Where Illinois sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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
$69.18
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.