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 $9.33 Median $9.33 Typical High $19.05 | Facility | None | $9.33 | $9.33 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $15.49 | Professional | None | $9.33 | $9.33 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
BCBS Illinois Setting Facility Modifier None Typical Low $22.91 Median $31.62 Typical High $128.82 | Facility | None | $22.91 | $31.62 | $128.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Hally Health Setting Professional Modifier None Typical Low $16.22 Median $21.88 Typical High $31.62 | Professional | None | $16.22 | $21.88 | $31.62 |
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 $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $15.85 | Professional | None | $10.96 | $10.96 | $15.85 |
United Setting Facility Modifier None Typical Low $12.59 Median $19.05 Typical High $30.90 | Facility | None | $12.59 | $19.05 | $30.90 |
United Setting Professional Modifier None Typical Low $8.51 Median $10.23 Typical High $22.91 | Professional | None | $8.51 | $10.23 | $22.91 |
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 $4.68 Median $4.68 Typical High $7.76 | Professional | 52 · Reduced service | $4.68 | $4.68 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.86 Typical High $3.09 | Professional | 53 · Discontinued | $1.86 | $1.86 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.41 Typical High $2.29 | Professional | 55 · Aftercare only | $1.41 | $1.41 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.93 Typical High $1.55 | Professional | 56 · Pre-op care only | $0.93 | $0.93 | $1.55 |
Where Illinois sits
The same service costs 3.0 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
$14.79
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.