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 $104.71 Median $104.71 Typical High $204.17 | Facility | None | $104.71 | $104.71 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $162.18 | Professional | None | $104.71 | $104.71 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $1,380.38 | Facility | None | $245.47 | $338.84 | $1,380.38 |
BCBS Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $158.49 | Professional | None | $125.89 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $295.12 | Professional | None | $162.18 | $204.17 | $295.12 |
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 $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
United Setting Facility Modifier None Typical Low $97.72 Median $295.12 Typical High $295.12 | Facility | None | $97.72 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $234.42 | Professional | None | $81.28 | $100.00 | $234.42 |
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 $51.29 Median $52.48 Typical High $74.13 | Professional | 52 · Reduced service | $51.29 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $29.51 | Professional | 53 · Discontinued | $20.42 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $22.39 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $14.79 |
Where Illinois sits
The same service costs 2.3 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· 21st of 51
$135
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.