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 $47.86 Median $47.86 Typical High $95.50 | Facility | None | $47.86 | $47.86 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $75.86 | Professional | None | $47.86 | $47.86 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
BCBS Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $645.65 | Facility | None | $114.82 | $158.49 | $645.65 |
BCBS Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | None | $57.54 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Hally Health Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $162.18 | Professional | None | $79.43 | $112.20 | $162.18 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | None | $57.54 | $57.54 | $77.62 |
United Setting Facility Modifier None Typical Low $44.67 Median $134.90 Typical High $134.90 | Facility | None | $44.67 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $109.65 | Professional | None | $38.02 | $46.77 | $109.65 |
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 $23.44 Median $23.99 Typical High $33.88 | Professional | 52 · Reduced service | $23.44 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.55 Typical High $13.80 | Professional | 53 · Discontinued | $9.33 | $9.55 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $10.23 | Professional | 55 · Aftercare only | $7.08 | $7.24 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.79 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.68 | $4.79 | $6.76 |
Where Illinois sits
The same service costs 2.6 times more in Kansas 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· 20th of 51
$63.10
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.