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 $58.88 Median $58.88 Typical High $117.49 | Facility | None | $58.88 | $58.88 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $93.33 | Professional | None | $58.88 | $58.88 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $794.33 | Facility | None | $141.25 | $194.98 | $794.33 |
BCBS Illinois Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | None | $79.43 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $173.78 | Professional | None | $97.72 | $125.89 | $173.78 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $97.72 | Professional | None | $66.07 | $66.07 | $97.72 |
United Setting Facility Modifier None Typical Low $61.66 Median $117.49 Typical High $169.82 | Facility | None | $61.66 | $117.49 | $169.82 |
United Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $134.90 | Professional | None | $47.86 | $57.54 | $134.90 |
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 $29.51 Median $29.51 Typical High $46.77 | Professional | 52 · Reduced service | $29.51 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $18.62 | Professional | 53 · Discontinued | $11.75 | $11.75 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $9.33 |
Where Illinois sits
The same service costs 3.5 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· 20th of 51
$79.43
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.