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 $38.02 Median $38.02 Typical High $75.86 | Facility | None | $38.02 | $38.02 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $53.70 | Professional | None | $36.31 | $38.02 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | None | $56.23 | $56.23 | $75.86 |
BCBS Illinois Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $512.86 | Facility | None | $91.20 | $125.89 | $512.86 |
BCBS Illinois Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $57.54 | Professional | None | $40.74 | $57.54 | $57.54 |
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 $58.88 Median $74.13 Typical High $104.71 | Professional | None | $58.88 | $74.13 | $104.71 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | None | $56.23 | $56.23 | $61.66 |
United Setting Facility Modifier None Typical Low $40.74 Median $75.86 Typical High $97.72 | Facility | None | $40.74 | $75.86 | $97.72 |
United Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $87.10 | Professional | None | $28.18 | $37.15 | $87.10 |
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 $18.20 Median $19.05 Typical High $26.92 | Professional | 52 · Reduced service | $18.20 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.59 Typical High $10.96 | Professional | 53 · Discontinued | $7.24 | $7.59 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.75 Typical High $8.13 | Professional | 55 · Aftercare only | $5.50 | $5.75 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.80 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.63 | $3.80 | $5.37 |
Where Illinois sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 18th of 51
$48.98
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.