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 $31.62 Median $36.31 Typical High $128.82 | Facility | None | $31.62 | $36.31 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | None | $31.62 | $31.62 | $32.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $95.50 Median $138.04 Typical High $269.15 | Facility | None | $95.50 | $138.04 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $81.28 | Facility | None | $43.65 | $63.10 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Hally Health Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $251.19 | Professional | None | $38.90 | $52.48 | $251.19 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Professional | None | $33.88 | $33.88 | $36.31 |
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 $15.85 Median $15.85 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.46 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.24 |
Where Illinois sits
The same service costs 2.3 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· 11th of 51
$39.81
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.