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 $31.62 Median $31.62 Typical High $63.10 | Facility | None | $31.62 | $31.62 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $51.29 | Professional | None | $31.62 | $31.62 | $51.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $426.58 | Facility | None | $75.86 | $104.71 | $426.58 |
BCBS Illinois Setting Professional Modifier None Typical Low $42.66 Median $47.86 Typical High $47.86 | Professional | None | $42.66 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $87.10 | Professional | None | $52.48 | $64.57 | $87.10 |
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 $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | None | $46.77 | $46.77 | $52.48 |
United Setting Facility Modifier None Typical Low $35.48 Median $63.10 Typical High $95.50 | Facility | None | $35.48 | $63.10 | $95.50 |
United Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $72.44 | Professional | None | $26.30 | $30.90 | $72.44 |
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 $15.85 Median $15.85 Typical High $24.55 | Professional | 52 · Reduced service | $15.85 | $15.85 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $9.77 | Professional | 53 · Discontinued | $6.46 | $6.46 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $7.41 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $4.90 |
Where Illinois sits
The same service costs 3.0 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· 17th of 51
$45.71
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.