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 $42.66 Median $42.66 Typical High $107.15 | Facility | None | $42.66 | $42.66 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | None | $42.66 | $42.66 | $48.98 |
BCBS Illinois Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $707.95 | Facility | None | $120.23 | $194.98 | $707.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | None | $52.48 | $52.48 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $114.82 | Professional | None | $53.70 | $114.82 | $114.82 |
Hally Health Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $114.82 | Professional | None | $14.79 | $21.38 | $114.82 |
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 $17.38 Median $17.78 Typical High $19.05 | Professional | None | $17.38 | $17.78 | $19.05 |
United Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $60.26 | Professional | None | $50.12 | $57.54 | $60.26 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Illinois sits
The same service costs 2.0 times more in Oregon 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· 13th of 51
$52.48
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.