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 $8.51 Median $12.02 Typical High $18.62 | Facility | None | $8.51 | $12.02 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | None | $8.51 | $8.51 | $8.91 |
BCBS Illinois Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $107.15 | Facility | None | $38.02 | $57.54 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $16.98 Typical High $20.42 | Facility | None | $11.48 | $16.98 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Hally Health Setting Professional Modifier None Typical Low $11.48 Median $15.85 Typical High $109.65 | Professional | None | $11.48 | $15.85 | $109.65 |
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 $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | None | $9.33 | $9.33 | $10.00 |
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 $4.27 Median $4.27 Typical High $4.37 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.78 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.32 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.87 |
Where Illinois sits
The same service costs 6.5 times more in Oklahoma 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· 12th of 51
$11.48
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.