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 $407.38 Median $407.38 Typical High $812.83 | Facility | None | $407.38 | $407.38 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $645.65 | Professional | None | $407.38 | $407.38 | $645.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $977.24 Median $1,318.26 Typical High $5,495.41 | Facility | None | $977.24 | $1,318.26 | $5,495.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $616.60 | Professional | None | $537.03 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,174.90 | Professional | None | $630.96 | $870.96 | $1,174.90 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | None | $602.56 | $602.56 | $660.69 |
United Setting Facility Modifier None Typical Low $478.63 Median $812.83 Typical High $1,288.25 | Facility | None | $478.63 | $812.83 | $1,288.25 |
United Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $954.99 | Professional | None | $354.81 | $398.11 | $954.99 |
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 $204.17 Median $204.17 Typical High $323.59 | Professional | 52 · Reduced service | $204.17 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $128.82 | Professional | 53 · Discontinued | $81.28 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $64.57 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $64.57 |
Where Illinois sits
The same service costs 3.2 times more in Hawaii 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· 22nd of 51
$550
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.