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 $75.86 Median $75.86 Typical High $162.18 | Facility | None | $75.86 | $75.86 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | None | $75.86 | $75.86 | $128.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $691.83 | Facility | None | $169.82 | $275.42 | $691.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | None | $100.00 | $100.00 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $223.87 | Facility | None | $125.89 | $186.21 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $151.36 | Professional | None | $75.86 | $102.33 | $151.36 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $102.33 | Professional | None | $85.11 | $100.00 | $102.33 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Illinois sits
The same service costs 2.9 times more in Arizona than in Alabama. 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· 6th of 51
$100
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.