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 $41.69 Median $60.26 Typical High $85.11 | Facility | None | $41.69 | $60.26 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $66.07 | Professional | None | $39.81 | $41.69 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $77.62 | Professional | None | $50.12 | $61.66 | $77.62 |
BCBS Illinois Setting Facility Modifier None Typical Low $97.72 Median $134.90 Typical High $549.54 | Facility | None | $97.72 | $134.90 | $549.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $61.66 | Professional | None | $40.74 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
Hally Health Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $117.49 | Professional | None | $67.61 | $83.18 | $117.49 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $67.61 | Professional | None | $26.30 | $26.30 | $67.61 |
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 $19.95 Median $20.89 Typical High $29.51 | Professional | 52 · Reduced service | $19.95 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.32 Typical High $11.75 | Professional | 53 · Discontinued | $7.94 | $8.32 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.17 Typical High $8.71 | Professional | 55 · Aftercare only | $5.89 | $6.17 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.17 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.98 | $4.17 | $5.89 |
Where Illinois sits
The same service costs 3.8 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
$58.88
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.