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 $190.55 Median $190.55 Typical High $389.05 | Facility | None | $190.55 | $190.55 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $309.03 | Professional | None | $190.55 | $190.55 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $2,630.27 | Facility | None | $467.74 | $645.65 | $2,630.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $575.44 | Professional | None | $323.59 | $426.58 | $575.44 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | None | $288.40 | $288.40 | $316.23 |
United Setting Facility Modifier None Typical Low $190.55 Median $389.05 Typical High $616.60 | Facility | None | $190.55 | $389.05 | $616.60 |
United Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $467.74 | Professional | None | $173.78 | $190.55 | $467.74 |
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 $93.33 Median $93.33 Typical High $154.88 | Professional | 52 · Reduced service | $93.33 | $93.33 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $46.77 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $30.90 |
Where Illinois sits
The same service costs 2.5 times more in Kansas than in Florida. 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
$295
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.