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 $23.99 Median $1,288.25 Typical High $5,623.41 | Facility | None | $23.99 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $21.38 Typical High $1,122.02 | Professional | None | $17.38 | $21.38 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $537.03 | Facility | None | $60.26 | $72.44 | $537.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $34.67 | Professional | None | $25.12 | $28.84 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $83.18 Typical High $144.54 | Facility | None | $60.26 | $83.18 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $36.31 | Professional | None | $18.20 | $22.39 | $36.31 |
Hally Health Setting Professional Modifier None Typical Low $18.20 Median $25.12 Typical High $112.20 | Professional | None | $18.20 | $25.12 | $112.20 |
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 $21.38 Median $21.88 Typical High $23.44 | Professional | None | $21.38 | $21.88 | $23.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $125.89 | Facility | None | $112.20 | $112.20 | $125.89 |
United Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $42.66 | Professional | None | $18.62 | $24.55 | $42.66 |
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 $8.71 Median $9.55 Typical High $9.77 | Professional | 52 · Reduced service | $8.71 | $9.55 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.80 Typical High $3.98 | Professional | 53 · Discontinued | $3.47 | $3.80 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.88 Typical High $2.95 | Professional | 55 · Aftercare only | $2.57 | $2.88 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.91 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.74 | $1.91 | $2.00 |
Where Illinois sits
The same service costs 40.7 times more in Tennessee than in New York. 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· 24th of 51
$28.84
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.