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 $38.90 Median $38.90 Typical High $77.62 | Facility | None | $38.90 | $38.90 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $61.66 | Professional | None | $38.90 | $38.90 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $93.33 Median $128.82 Typical High $524.81 | Facility | None | $93.33 | $128.82 | $524.81 |
BCBS Illinois Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $58.88 | Professional | None | $51.29 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Hally Health Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $114.82 | Professional | None | $64.57 | $87.10 | $114.82 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | None | $57.54 | $57.54 | $63.10 |
United Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $123.03 | Facility | None | $50.12 | $77.62 | $123.03 |
United Setting Professional Modifier None Typical Low $33.88 Median $38.02 Typical High $91.20 | Professional | None | $33.88 | $38.02 | $91.20 |
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 $19.50 Median $19.50 Typical High $30.20 | Professional | 52 · Reduced service | $19.50 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $12.02 | Professional | 53 · Discontinued | $7.76 | $7.76 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.91 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $6.03 |
Where Illinois sits
The same service costs 4.7 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
$54.95
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.