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 $14.45 Median $14.45 Typical High $28.84 | Facility | None | $14.45 | $14.45 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $20.89 | Professional | None | $14.13 | $14.45 | $20.89 |
BCBS Setting Facility Modifier None Typical Low $34.67 Median $46.77 Typical High $194.98 | Facility | None | $34.67 | $46.77 | $194.98 |
BCBS Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | None | $19.05 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
Hally Health Setting Professional Modifier None Typical Low $23.99 Median $30.20 Typical High $40.74 | Professional | None | $23.99 | $30.20 | $40.74 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $13.49 Median $41.69 Typical High $41.69 | Facility | None | $13.49 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $11.48 Median $14.13 Typical High $33.11 | Professional | None | $11.48 | $14.13 | $33.11 |
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 $7.08 Median $7.24 Typical High $10.47 | Professional | 52 · Reduced service | $7.08 | $7.24 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.88 Typical High $4.17 | Professional | 53 · Discontinued | $2.82 | $2.88 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.19 Typical High $3.09 | Professional | 55 · Aftercare only | $2.14 | $2.19 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $2.09 |
Where Illinois sits
The same service costs 5.5 times more in Kansas than in Delaware. 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· 20th of 51
$19.05
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.