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 $69.18 Median $69.18 Typical High $138.04 | Facility | None | $69.18 | $69.18 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $109.65 | Professional | None | $69.18 | $70.79 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | None | $87.10 | $87.10 | $93.33 |
BCBS Illinois Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $933.25 | Facility | None | $165.96 | $229.09 | $933.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | None | $83.18 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $204.17 | Professional | None | $114.82 | $147.91 | $204.17 |
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 $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $112.20 | Professional | None | $77.62 | $77.62 | $112.20 |
United Setting Facility Modifier None Typical Low $91.20 Median $138.04 Typical High $218.78 | Facility | None | $91.20 | $138.04 | $218.78 |
United Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $165.96 | Professional | None | $61.66 | $67.61 | $165.96 |
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 $34.67 Median $34.67 Typical High $53.70 | Professional | 52 · Reduced service | $34.67 | $34.67 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $21.38 | Professional | 53 · Discontinued | $13.80 | $13.80 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $16.22 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $10.72 |
Where Illinois sits
The same service costs 5.0 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
$93.33
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.