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 $186.21 Median $186.21 Typical High $281.84 | Facility | None | $186.21 | $186.21 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $239.88 | Professional | None | $186.21 | $186.21 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | None | $141.25 | $141.25 | $186.21 |
BCBS Illinois Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,548.82 | Facility | None | $602.56 | $1,174.90 | $1,548.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | None | $199.53 | $199.53 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $371.54 Typical High $446.68 | Facility | None | $251.19 | $371.54 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $398.11 | Professional | None | $177.83 | $251.19 | $398.11 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $457.09 | Facility | None | $177.83 | $177.83 | $457.09 |
United Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $199.53 | Professional | None | $154.88 | $186.21 | $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 $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
Where Illinois sits
The same service costs 6.6 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· 11th of 51
$200
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.