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 $60.26 Median $61.66 Typical High $125.89 | Facility | None | $60.26 | $61.66 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $95.50 | Professional | None | $60.26 | $60.26 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $95.50 | Professional | None | $57.54 | $75.86 | $95.50 |
BCBS Illinois Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $812.83 | Facility | None | $141.25 | $194.98 | $812.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $91.20 | Professional | None | $64.57 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $169.82 | Professional | None | $93.33 | $117.49 | $169.82 |
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 $30.90 Median $30.90 Typical High $97.72 | Professional | None | $30.90 | $30.90 | $97.72 |
United Setting Facility Modifier None Typical Low $67.61 Median $120.23 Typical High $165.96 | Facility | None | $67.61 | $120.23 | $165.96 |
United Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $134.90 | Professional | None | $45.71 | $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 $28.84 Median $30.20 Typical High $42.66 | Professional | 52 · Reduced service | $28.84 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.02 Typical High $16.98 | Professional | 53 · Discontinued | $11.48 | $12.02 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $12.88 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.03 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.75 | $6.03 | $8.51 |
Where Illinois sits
The same service costs 4.1 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· 19th 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.