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 $194.98 Median $194.98 Typical High $389.05 | Facility | None | $194.98 | $194.98 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $309.03 | Professional | None | $194.98 | $194.98 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $309.03 | Professional | None | $239.88 | $288.40 | $309.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $467.74 Median $630.96 Typical High $2,630.27 | Facility | None | $467.74 | $630.96 | $2,630.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | None | $257.04 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $524.81 | Professional | None | $302.00 | $380.19 | $524.81 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
United Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $549.54 | Facility | None | $389.05 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $446.68 | Professional | None | $154.88 | $190.55 | $446.68 |
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 $97.72 Median $97.72 Typical High $144.54 | Professional | 52 · Reduced service | $97.72 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $57.54 | Professional | 53 · Discontinued | $38.90 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $28.84 |
Where Illinois sits
The same service costs 2.4 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· 16th of 51
$269
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.