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 $9.55 Median $16.22 Typical High $35.48 | Facility | None | $9.55 | $16.22 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $10.23 | Professional | None | $9.55 | $9.55 | $10.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $4.90 Median $39.81 Typical High $85.11 | Facility | None | $4.90 | $39.81 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $20.42 Typical High $24.55 | Facility | None | $13.80 | $20.42 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Hally Health Setting Professional Modifier None Typical Low $15.49 Median $21.38 Typical High $100.00 | Professional | None | $15.49 | $21.38 | $100.00 |
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 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $17.38 | Professional | None | $5.25 | $5.25 | $17.38 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $8.71 | Facility | None | $3.89 | $3.89 | $8.71 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | None | $10.00 | $10.00 | $10.72 |
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 $4.79 Median $4.79 Typical High $5.13 | Professional | 52 · Reduced service | $4.79 | $4.79 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $2.04 | Professional | 53 · Discontinued | $1.91 | $1.91 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.02 |
Where Illinois sits
The same service costs 9.1 times more in Alabama than in Virginia. 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· 35th of 51
$10.23
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.