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 $26.92 Median $26.92 Typical High $53.70 | Facility | None | $26.92 | $26.92 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $41.69 | Professional | None | $26.92 | $26.92 | $41.69 |
BCBS Illinois Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $426.58 | Facility | None | $63.10 | $89.13 | $426.58 |
BCBS Illinois Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $40.74 | Professional | None | $33.11 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Hally Health Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $79.43 | Professional | None | $46.77 | $60.26 | $79.43 |
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 $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $43.65 | Professional | None | $14.79 | $14.79 | $43.65 |
United Setting Facility Modifier None Typical Low $53.70 Median $75.86 Typical High $75.86 | Facility | None | $53.70 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $61.66 | Professional | None | $20.89 | $25.70 | $61.66 |
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 $13.49 Median $13.49 Typical High $19.95 | Professional | 52 · Reduced service | $13.49 | $13.49 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $7.94 | Professional | 53 · Discontinued | $5.37 | $5.37 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $5.89 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $3.98 |
Where Illinois sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$35.48
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.