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 $25.70 Median $51.29 Typical High $190.55 | Facility | None | $25.70 | $51.29 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $47.86 Median $114.82 Typical High $467.74 | Facility | None | $47.86 | $114.82 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $107.15 Typical High $128.82 | Facility | None | $72.44 | $107.15 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Hally Health Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $199.53 | Professional | None | $67.61 | $125.89 | $199.53 |
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 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $79.43 Median $81.28 Typical High $93.33 | Facility | None | $79.43 | $81.28 | $93.33 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | None | $52.48 | $52.48 | $56.23 |
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 $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Where Illinois sits
The same service costs 6.6 times more in Alabama 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· 21st of 51
$53.70
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.