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 $11.48 Median $19.50 Typical High $42.66 | Facility | None | $11.48 | $19.50 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $12.59 | Professional | None | $11.22 | $11.48 | $12.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $20.42 Median $46.77 Typical High $95.50 | Facility | None | $20.42 | $46.77 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $22.91 Typical High $27.54 | Facility | None | $15.49 | $22.91 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $18.20 Typical High $37.15 | Professional | None | $12.88 | $18.20 | $37.15 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $25.70 | Facility | None | $11.48 | $11.48 | $25.70 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | None | $11.75 | $11.75 | $12.30 |
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 $5.62 Median $5.62 Typical High $5.75 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.74 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.15 |
Where Illinois sits
The same service costs 1.8 times more in Alaska 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· 23rd of 51
$12.30
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.