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 $7.76 Median $10.96 Typical High $15.49 | Facility | None | $7.76 | $10.96 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $13.18 | Professional | None | $7.76 | $7.76 | $13.18 |
BCBS Illinois Setting Facility Modifier None Typical Low $15.85 Median $22.91 Typical High $48.98 | Facility | None | $15.85 | $22.91 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $15.49 Typical High $18.62 | Facility | None | $10.47 | $15.49 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Hally Health Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $26.92 | Professional | None | $8.13 | $12.30 | $26.92 |
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 Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.71 | Professional | None | $8.13 | $8.13 | $8.71 |
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 $3.89 Median $3.89 Typical High $3.98 | Professional | 52 · Reduced service | $3.89 | $3.89 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.55 Typical High $1.58 | Professional | 53 · Discontinued | $1.55 | $1.55 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $1.20 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $0.79 |
Where Illinois sits
The same service costs 2.6 times more in Texas than in Oklahoma. 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· 8th of 51
$10.47
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.