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 $0.62 Median $1.05 Typical High $2.34 | Facility | None | $0.62 | $1.05 | $2.34 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | None | $0.62 | $0.62 | $0.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 52 · Reduced service | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
BCBS Illinois Setting Facility Modifier None Typical Low $2.57 Median $3.80 Typical High $8.71 | Facility | None | $2.57 | $3.80 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $1.23 Typical High $1.45 | Facility | None | $0.81 | $1.23 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Hally Health Setting Professional Modifier None Typical Low $0.55 Median $0.66 Typical High $2.45 | Professional | None | $0.55 | $0.66 | $2.45 |
Hally Health Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | None | $0.72 | $0.72 | $0.72 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | None | $0.65 | $0.65 | $0.68 |
1 more rate 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 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Illinois sits
The same service costs 4.7 times more in Wyoming than in Georgia. 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· 30th of 51
$0.65
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.