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 $10.96 Median $15.49 Typical High $41.69 | Facility | None | $10.96 | $15.49 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $12.59 | Professional | None | $10.96 | $10.96 | $12.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $22.91 Median $48.98 Typical High $100.00 | Facility | None | $22.91 | $48.98 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $21.88 Typical High $26.30 | Facility | None | $14.79 | $21.88 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Hally Health Setting Professional Modifier None Typical Low $10.96 Median $43.65 Typical High $67.61 | Professional | None | $10.96 | $43.65 | $67.61 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $25.12 | Facility | None | $10.96 | $10.96 | $25.12 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.02 | Professional | None | $11.22 | $11.22 | $12.02 |
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 $5.50 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.10 |
Where Illinois sits
The same service costs 3.7 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· 28th 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.