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 $81.28 Median $81.28 Typical High $158.49 | Facility | None | $81.28 | $81.28 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $125.89 | Professional | None | $81.28 | $81.28 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $158.49 | Professional | None | $112.20 | $120.23 | $158.49 |
BCBS Illinois Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $1,071.52 | Facility | None | $190.55 | $263.03 | $1,071.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $123.03 | Professional | None | $91.20 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $223.87 | Professional | None | $134.90 | $158.49 | $223.87 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | None | $117.49 | $117.49 | $131.83 |
United Setting Facility Modifier None Typical Low $87.10 Median $229.09 Typical High $229.09 | Facility | None | $87.10 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $181.97 | Professional | None | $64.57 | $77.62 | $181.97 |
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 $40.74 Median $40.74 Typical High $64.57 | Professional | 52 · Reduced service | $40.74 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $25.70 | Professional | 53 · Discontinued | $16.22 | $16.22 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $19.05 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $12.88 |
Where Illinois sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 22nd of 51
$107
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.