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 $95.50 | Professional | None | $58.88 | $58.88 | $95.50 |
BCBS Illinois Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $1,122.02 | Facility | None | $141.25 | $169.82 | $1,122.02 |
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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $162.18 | Professional | None | $97.72 | $120.23 | $162.18 |
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 $87.10 Median $87.10 Typical High $97.72 | Professional | None | $87.10 | $87.10 | $97.72 |
United Setting Facility Modifier None Typical Low $57.54 Median $117.49 Typical High $169.82 | Facility | None | $57.54 | $117.49 | $169.82 |
United Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $134.90 | Professional | None | $51.29 | $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 $43.65 | Professional | 52 · Reduced service | $29.51 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $19.05 | Professional | 53 · Discontinued | $12.02 | $12.02 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $13.18 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $8.71 |
Where Illinois sits
The same service costs 2.4 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· 18th 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.