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 $19.50 Median $19.50 Typical High $38.90 | Facility | None | $19.50 | $19.50 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $28.84 | Professional | None | $19.50 | $19.50 | $28.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $46.77 Median $64.57 Typical High $263.03 | Facility | None | $46.77 | $64.57 | $263.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $29.51 | Professional | None | $25.70 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Hally Health Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $58.88 | Professional | None | $34.67 | $43.65 | $58.88 |
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 $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $32.36 | Professional | None | $28.84 | $28.84 | $32.36 |
United Setting Facility Modifier None Typical Low $38.90 Median $56.23 Typical High $56.23 | Facility | None | $38.90 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $15.49 Median $19.05 Typical High $44.67 | Professional | None | $15.49 | $19.05 | $44.67 |
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 $9.77 Median $9.77 Typical High $14.45 | Professional | 52 · Reduced service | $9.77 | $9.77 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $5.89 | Professional | 53 · Discontinued | $3.98 | $3.98 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $4.37 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.95 |
Where Illinois sits
The same service costs 2.2 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· 21st of 51
$25.70
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.