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 $0.65 Median $1.10 Typical High $2.51 | Facility | None | $0.65 | $1.10 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.71 | Professional | None | $0.65 | $0.65 | $0.71 |
BCBS Illinois Setting Facility Modifier None Typical Low $2.14 Median $3.31 Typical High $8.71 | Facility | None | $2.14 | $3.31 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $0.85 Median $1.29 Typical High $1.55 | Facility | None | $0.85 | $1.29 | $1.55 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Hally Health Setting Professional Modifier None Typical Low $0.76 Median $1.02 Typical High $5.25 | Professional | None | $0.76 | $1.02 | $5.25 |
Hally Health Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.72 | Professional | None | $0.68 | $0.68 | $0.72 |
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 $0.32 Median $0.32 Typical High $0.32 | Professional | 52 · Reduced service | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Illinois sits
The same service costs 2.6 times more in Texas than in Wyoming. 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· 23rd of 51
$0.71
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.