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 $45.71 Median $45.71 Typical High $91.20 | Facility | None | $45.71 | $45.71 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | None | $45.71 | $45.71 | $66.07 |
BCBS Illinois Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $616.60 | Facility | None | $109.65 | $151.36 | $616.60 |
BCBS Illinois Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $69.18 | Professional | None | $57.54 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Hally Health Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $128.82 | Professional | None | $79.43 | $93.33 | $128.82 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | None | $67.61 | $67.61 | $74.13 |
United Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $128.82 | Facility | None | $91.20 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $36.31 Median $44.67 Typical High $104.71 | Professional | None | $36.31 | $44.67 | $104.71 |
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 $22.91 Median $22.91 Typical High $33.88 | Professional | 52 · Reduced service | $22.91 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $13.49 | Professional | 53 · Discontinued | $9.12 | $9.12 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $10.23 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.76 |
Where Illinois sits
The same service costs 3.1 times more in Hawaii than in Kansas. 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· 18th of 51
$61.66
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.