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 $5.50 Median $5.50 Typical High $11.22 | Facility | None | $5.50 | $5.50 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $9.12 | Professional | None | $5.50 | $5.50 | $9.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $13.49 Median $18.62 Typical High $75.86 | Facility | None | $13.49 | $18.62 | $75.86 |
BCBS Illinois Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Hally Health Setting Professional Modifier None Typical Low $10.00 Median $12.30 Typical High $16.60 | Professional | None | $10.00 | $12.30 | $16.60 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $9.33 | Professional | None | $6.31 | $6.31 | $9.33 |
United Setting Facility Modifier None Typical Low $6.31 Median $11.22 Typical High $18.20 | Facility | None | $6.31 | $11.22 | $18.20 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.50 Typical High $13.49 | Professional | None | $5.01 | $5.50 | $13.49 |
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 $2.75 Median $2.75 Typical High $4.47 | Professional | 52 · Reduced service | $2.75 | $2.75 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.82 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $1.35 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.89 |
Where Illinois sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 16th of 51
$8.51
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.