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 $346.74 Median $346.74 Typical High $691.83 | Facility | None | $346.74 | $346.74 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $478.63 | Professional | None | $309.03 | $346.74 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $691.83 | Professional | None | $416.87 | $416.87 | $691.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $4,677.35 | Facility | None | $831.76 | $1,148.15 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $524.81 | Professional | None | $316.23 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $954.99 | Professional | None | $512.86 | $676.08 | $954.99 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | None | $512.86 | $512.86 | $575.44 |
United Setting Facility Modifier None Typical Low $338.84 Median $691.83 Typical High $831.76 | Facility | None | $338.84 | $691.83 | $831.76 |
United Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $794.33 | Professional | None | $234.42 | $338.84 | $794.33 |
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 $151.36 Median $173.78 Typical High $245.47 | Professional | 52 · Reduced service | $151.36 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $100.00 | Professional | 53 · Discontinued | $61.66 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $74.13 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $50.12 |
Where Illinois sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 15th of 51
$437
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.