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 $1.51 Median $1.74 Typical High $6.31 | Facility | None | $1.51 | $1.74 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $1.12 Median $2.40 Typical High $8.51 | Facility | None | $1.12 | $2.40 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $3.47 Typical High $4.17 | Facility | None | $2.34 | $3.47 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Hally Health Setting Professional Modifier None Typical Low $0.91 Median $1.66 Typical High $2.34 | Professional | None | $0.91 | $1.66 | $2.34 |
Hally Health Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $3.98 | Facility | None | $1.74 | $1.74 | $3.98 |
United Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.82 | Professional | None | $1.70 | $1.70 | $1.82 |
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 $0.87 Median $0.87 Typical High $0.87 | Professional | 52 · Reduced service | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 53 · Discontinued | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.18 |
Where Illinois sits
The same service costs 1.7 times more in Arizona than in Mississippi. 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
$1.74
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.