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 $218.78 Median $218.78 Typical High $436.52 | Facility | None | $218.78 | $218.78 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $338.84 | Professional | None | $204.17 | $218.78 | $338.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $2,951.21 | Facility | None | $524.81 | $707.95 | $2,951.21 |
BCBS Illinois Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | None | $257.04 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $512.86 | Professional | None | $269.15 | $389.05 | $512.86 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | None | $316.23 | $316.23 | $354.81 |
United Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $562.34 | Facility | None | $229.09 | $436.52 | $562.34 |
United Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $501.19 | Professional | None | $158.49 | $213.80 | $501.19 |
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 $107.15 Median $109.65 Typical High $154.88 | Professional | 52 · Reduced service | $107.15 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $43.65 Typical High $61.66 | Professional | 53 · Discontinued | $42.66 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $46.77 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.88 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.38 | $21.88 | $30.90 |
Where Illinois sits
The same service costs 3.5 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· 17th of 51
$275
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.