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 $23.44 Median $23.44 Typical High $46.77 | Facility | None | $23.44 | $23.44 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $37.15 | Professional | None | $23.44 | $23.44 | $37.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $316.23 | Facility | None | $56.23 | $77.62 | $316.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $35.48 | Professional | None | $30.90 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $64.57 | Professional | None | $40.74 | $47.86 | $64.57 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | None | $34.67 | $34.67 | $38.02 |
United Setting Facility Modifier None Typical Low $46.77 Median $67.61 Typical High $67.61 | Facility | None | $46.77 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $18.62 Median $22.91 Typical High $53.70 | Professional | None | $18.62 | $22.91 | $53.70 |
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 $11.75 Median $11.75 Typical High $17.38 | Professional | 52 · Reduced service | $11.75 | $11.75 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $6.92 | Professional | 53 · Discontinued | $4.68 | $4.68 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $5.25 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $3.47 |
Where Illinois sits
The same service costs 2.5 times more in Montana 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· 18th of 51
$33.11
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.