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 $2.82 Median $4.90 Typical High $11.22 | Facility | None | $2.82 | $4.90 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $3.02 | Professional | None | $2.82 | $2.82 | $3.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $9.33 Median $14.13 Typical High $25.12 | Facility | None | $9.33 | $14.13 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $5.75 Typical High $6.92 | Facility | None | $3.89 | $5.75 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Hally Health Setting Professional Modifier None Typical Low $3.09 Median $4.37 Typical High $26.30 | Professional | None | $3.09 | $4.37 | $26.30 |
Hally Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.24 | Professional | None | $3.09 | $3.09 | $3.24 |
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 $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 53 · Discontinued | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Where Illinois sits
The same service costs 2.0 times more in Wyoming than in Florida. 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· 36th of 51
$3.09
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.