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 $39.81 Median $39.81 Typical High $81.28 | Facility | None | $39.81 | $39.81 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $64.57 | Professional | None | $39.81 | $39.81 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
BCBS Illinois Setting Facility Modifier None Typical Low $97.72 Median $134.90 Typical High $549.54 | Facility | None | $97.72 | $134.90 | $549.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Hally Health Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $120.23 | Professional | None | $72.44 | $91.20 | $120.23 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $67.61 | Professional | None | $45.71 | $45.71 | $67.61 |
United Setting Facility Modifier None Typical Low $53.70 Median $81.28 Typical High $131.83 | Facility | None | $53.70 | $81.28 | $131.83 |
United Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $97.72 | Professional | None | $36.31 | $39.81 | $97.72 |
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 $19.95 Median $19.95 Typical High $32.36 | Professional | 52 · Reduced service | $19.95 | $19.95 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $13.18 | Professional | 53 · Discontinued | $7.94 | $7.94 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $9.77 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $6.46 |
Where Illinois sits
The same service costs 4.9 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
$61.66
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.