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 $6.46 | Facility | None | $1.51 | $1.74 | $6.46 |
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 $3.31 Median $6.31 Typical High $13.80 | Facility | None | $3.31 | $6.31 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $3.47 Typical High $4.17 | Facility | None | $2.29 | $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 $1.48 Median $2.00 Typical High $3.09 | Professional | None | $1.48 | $2.00 | $3.09 |
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 $3.89 | Facility | None | $1.74 | $1.74 | $3.89 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.86 | Professional | None | $1.74 | $1.74 | $1.86 |
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 $0.85 Median $0.85 Typical High $0.85 | Professional | 52 · Reduced service | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 53 · Discontinued | $0.34 | $0.34 | $0.34 |
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 $0.17 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.17 |
Where Illinois sits
The same service costs 1.8 times more in Alaska than in Virginia. 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· 34th 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.