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 $12.59 Median $12.59 Typical High $25.70 | Facility | None | $12.59 | $12.59 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $20.42 | Professional | None | $12.59 | $12.59 | $20.42 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
BCBS Illinois Setting Facility Modifier None Typical Low $30.90 Median $42.66 Typical High $173.78 | Facility | None | $30.90 | $42.66 | $173.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Hally Health Setting Professional Modifier None Typical Low $21.38 Median $28.18 Typical High $38.90 | Professional | None | $21.38 | $28.18 | $38.90 |
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 $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $20.89 | Professional | None | $14.45 | $14.45 | $20.89 |
United Setting Facility Modifier None Typical Low $12.88 Median $25.70 Typical High $38.02 | Facility | None | $12.88 | $25.70 | $38.02 |
United Setting Professional Modifier None Typical Low $11.22 Median $12.59 Typical High $29.51 | Professional | None | $11.22 | $12.59 | $29.51 |
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 $6.17 Median $6.17 Typical High $10.23 | Professional | 52 · Reduced service | $6.17 | $6.17 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $4.07 | Professional | 53 · Discontinued | $2.51 | $2.51 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $3.09 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $2.04 |
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· 19th of 51
$19.50
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.