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 $40.74 Median $40.74 Typical High $81.28 | Facility | None | $40.74 | $40.74 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $63.10 | Professional | None | $40.74 | $40.74 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $120.23 | Professional | None | $19.95 | $19.95 | $120.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $97.72 Median $131.83 Typical High $549.54 | Facility | None | $97.72 | $131.83 | $549.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $61.66 | Professional | None | $44.67 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Facility | None | $46.77 | $46.77 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Hally Health Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $120.23 | Professional | None | $67.61 | $87.10 | $120.23 |
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 $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $66.07 | Professional | None | $36.31 | $36.31 | $66.07 |
United Setting Facility Modifier None Typical Low $43.65 Median $81.28 Typical High $107.15 | Facility | None | $43.65 | $81.28 | $107.15 |
United Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $93.33 | Professional | None | $30.20 | $39.81 | $93.33 |
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 $20.42 Median $20.42 Typical High $28.84 | Professional | 52 · Reduced service | $20.42 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $11.48 | Professional | 53 · Discontinued | $8.13 | $8.13 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $8.71 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $5.75 |
Where Illinois sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 15th of 51
$57.54
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.