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 $162.18 | Facility | None | $81.28 | $81.28 | $162.18 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $1,096.48 | Facility | None | $190.55 | $263.03 | $1,096.48 |
BCBS Illinois Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | None | $102.33 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $218.78 | Professional | None | $125.89 | $158.49 | $218.78 |
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 $131.83 Median $138.04 Typical High $138.04 | Professional | None | $131.83 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $77.62 Median $229.09 Typical High $229.09 | Facility | None | $77.62 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $186.21 | Professional | None | $63.10 | $79.43 | $186.21 |
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 $60.26 | Professional | 52 · Reduced service | $40.74 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $16.22 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $17.78 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $12.02 |
Where Illinois sits
The same service costs 2.8 times more in Kansas 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· 21st of 51
$105
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.