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 $12.59 Median $17.38 Typical High $21.38 | Facility | None | $12.59 | $17.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $14.79 | Professional | None | $12.59 | $12.59 | $14.79 |
BCBS Illinois Setting Facility Modifier None Typical Low $63.10 Median $120.23 Typical High $251.19 | Facility | None | $63.10 | $120.23 | $251.19 |
BCBS Illinois Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | None | $12.88 | $12.88 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $26.30 Typical High $31.62 | Facility | None | $17.78 | $26.30 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Hally Health Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $158.49 | Professional | None | $54.95 | $93.33 | $158.49 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $14.79 | Professional | None | $12.88 | $12.88 | $14.79 |
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 $6.31 Median $6.31 Typical High $6.46 | Professional | 52 · Reduced service | $6.31 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.57 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.91 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $1.29 |
Where Illinois sits
The same service costs 11.0 times more in Kansas 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· 33rd of 51
$13.18
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.