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 $16.98 Median $20.42 Typical High $37.15 | Facility | None | $16.98 | $20.42 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $58.88 | Professional | None | $20.42 | $20.42 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
BCBS Illinois Setting Facility Modifier None Typical Low $44.67 Median $100.00 Typical High $416.87 | Facility | None | $44.67 | $100.00 | $416.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $29.51 Median $37.15 Typical High $37.15 | Professional | None | $29.51 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Hally Health Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $97.72 | Professional | None | $30.90 | $41.69 | $97.72 |
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 $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $44.67 | Professional | None | $15.49 | $18.20 | $44.67 |
5 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 $8.51 Median $10.23 Typical High $15.49 | Professional | 52 · Reduced service | $8.51 | $10.23 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $4.07 Typical High $6.31 | Professional | 53 · Discontinued | $3.39 | $4.07 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $15.49 Typical High $23.44 | Professional | 54 · Surgery only | $12.88 | $15.49 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $3.09 Typical High $4.68 | Professional | 55 · Aftercare only | $2.51 | $3.09 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.04 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.70 | $2.04 | $3.16 |
Where Illinois sits
The same service costs 3.1 times more in Rhode Island than in New York. 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· 22nd of 51
$29.51
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.