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 $389.05 Median $389.05 Typical High $776.25 | Facility | None | $389.05 | $389.05 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $549.54 | Professional | None | $380.19 | $389.05 | $549.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $7,413.10 | Facility | None | $933.25 | $1,122.02 | $7,413.10 |
BCBS Illinois Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | None | $457.09 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $977.24 | Professional | None | $602.56 | $758.58 | $977.24 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | None | $575.44 | $575.44 | $630.96 |
United Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $436.52 | $1,071.52 | $1,071.52 |
United Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $891.25 | Professional | None | $295.12 | $380.19 | $891.25 |
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 $190.55 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $190.55 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $77.62 Typical High $112.20 | Professional | 53 · Discontinued | $75.86 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $38.90 | $54.95 |
Where Illinois sits
The same service costs 3.5 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· 19th of 51
$468
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.