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 $288.40 Median $288.40 Typical High $602.56 | Facility | None | $288.40 | $288.40 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $478.63 | Professional | None | $288.40 | $288.40 | $478.63 |
BCBS Illinois Setting Facility Modifier None Typical Low $724.44 Median $977.24 Typical High $4,073.80 | Facility | None | $724.44 | $977.24 | $4,073.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $851.14 | Professional | None | $501.19 | $645.65 | $851.14 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Molina Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | None | $467.74 | $467.74 | $489.78 |
United Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $954.99 | Facility | None | $346.74 | $602.56 | $954.99 |
United Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $707.95 | Professional | None | $263.03 | $295.12 | $707.95 |
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 $144.54 Median $144.54 Typical High $239.88 | Professional | 52 · Reduced service | $144.54 | $144.54 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $95.50 | Professional | 53 · Discontinued | $57.54 | $57.54 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $72.44 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $47.86 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $47.86 |
Where Illinois sits
The same service costs 3.2 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
$457
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.