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 $89.13 Median $89.13 Typical High $177.83 | Facility | None | $89.13 | $89.13 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | None | $89.13 | $89.13 | $131.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $1,202.26 | Facility | None | $213.80 | $288.40 | $1,202.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | None | $117.49 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $239.88 | Professional | None | $141.25 | $173.78 | $239.88 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | None | $144.54 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $57.54 Median $251.19 Typical High $251.19 | Facility | None | $57.54 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $204.17 | Professional | None | $69.18 | $87.10 | $204.17 |
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 $44.67 Median $44.67 Typical High $66.07 | Professional | 52 · Reduced service | $44.67 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $26.30 | Professional | 53 · Discontinued | $17.78 | $17.78 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $13.18 |
Where Illinois sits
The same service costs 2.1 times more in Montana than in Florida. 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· 19th of 51
$117
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.