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 $138.04 Median $138.04 Typical High $549.54 | Facility | None | $138.04 | $138.04 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $323.59 Median $512.86 Typical High $1,230.27 | Facility | None | $323.59 | $512.86 | $1,230.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $371.54 Typical High $436.52 | Facility | None | $245.47 | $371.54 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $426.58 | Professional | None | $134.90 | $190.55 | $426.58 |
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 $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $309.03 | Facility | None | $138.04 | $138.04 | $309.03 |
United Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $199.53 | Professional | None | $141.25 | $169.82 | $199.53 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where Illinois sits
The same service costs 1.8 times more in Arizona than in Rhode Island. 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· 5th of 51
$191
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.