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 $33.88 Median $33.88 Typical High $67.61 | Facility | None | $33.88 | $33.88 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $50.12 | Professional | None | $33.88 | $33.88 | $50.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $457.09 | Facility | None | $81.28 | $112.20 | $457.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $51.29 | Professional | None | $44.67 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $95.50 | Professional | None | $58.88 | $72.44 | $95.50 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
United Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $95.50 | Facility | None | $67.61 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $77.62 | Professional | None | $26.92 | $33.11 | $77.62 |
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 $16.98 Median $16.98 Typical High $25.12 | Professional | 52 · Reduced service | $16.98 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $10.00 | Professional | 53 · Discontinued | $6.76 | $6.76 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $7.59 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $5.01 |
Where Illinois sits
The same service costs 2.6 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· 19th of 51
$44.67
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.