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 $14.13 Median $14.13 Typical High $28.84 | Facility | None | $14.13 | $14.13 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $23.44 | Professional | None | $14.13 | $14.13 | $23.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $34.67 Median $47.86 Typical High $194.98 | Facility | None | $34.67 | $47.86 | $194.98 |
BCBS Illinois Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Hally Health Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $42.66 | Professional | None | $23.99 | $32.36 | $42.66 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $23.99 | Professional | None | $16.60 | $16.60 | $23.99 |
United Setting Facility Modifier None Typical Low $14.45 Median $28.84 Typical High $43.65 | Facility | None | $14.45 | $28.84 | $43.65 |
United Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $33.11 | Professional | None | $12.88 | $14.13 | $33.11 |
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 $7.08 Median $7.08 Typical High $11.75 | Professional | 52 · Reduced service | $7.08 | $7.08 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $4.68 | Professional | 53 · Discontinued | $2.82 | $2.82 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $3.47 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $2.34 |
Where Illinois sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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
$21.88
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.