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 $50.12 Median $50.12 Typical High $100.00 | Facility | None | $50.12 | $50.12 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $79.43 | Professional | None | $50.12 | $51.29 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $74.13 | Professional | None | $56.23 | $74.13 | $74.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $120.23 Median $165.96 Typical High $676.08 | Facility | None | $120.23 | $165.96 | $676.08 |
BCBS Illinois Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | None | $60.26 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $154.88 | Professional | None | $83.18 | $112.20 | $154.88 |
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 $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | None | $74.13 | $74.13 | $81.28 |
United Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $158.49 | Facility | None | $64.57 | $100.00 | $158.49 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $117.49 | Professional | None | $43.65 | $48.98 | $117.49 |
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 $25.12 Median $25.12 Typical High $38.90 | Professional | 52 · Reduced service | $25.12 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $15.49 | Professional | 53 · Discontinued | $10.00 | $10.00 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $11.48 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $7.76 |
Where Illinois sits
The same service costs 5.0 times more in Hawaii 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· 24th of 51
$72.44
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.