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 $54.95 Median $54.95 Typical High $107.15 | Facility | None | $54.95 | $54.95 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $85.11 | Professional | None | $54.95 | $54.95 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $95.50 | Professional | None | $79.43 | $81.28 | $95.50 |
BCBS Illinois Setting Facility Modifier None Typical Low $128.82 Median $154.88 Typical High $1,047.13 | Facility | None | $128.82 | $154.88 | $1,047.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | None | $74.13 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Facility | None | $60.26 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Hally Health Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $154.88 | Professional | None | $91.20 | $107.15 | $154.88 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $89.13 | Professional | None | $26.30 | $26.30 | $89.13 |
United Setting Facility Modifier None Typical Low $72.44 Median $107.15 Typical High $154.88 | Facility | None | $72.44 | $107.15 | $154.88 |
United Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $123.03 | Professional | None | $45.71 | $52.48 | $123.03 |
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 $26.92 Median $26.92 Typical High $38.90 | Professional | 52 · Reduced service | $26.92 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $15.49 | Professional | 53 · Discontinued | $10.96 | $10.96 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $11.48 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.76 |
Where Illinois sits
The same service costs 2.1 times more in Wisconsin 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· 18th of 51
$77.62
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.