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 $7.08 Median $8.51 Typical High $15.49 | Facility | None | $7.08 | $8.51 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $15.14 | Professional | None | $8.51 | $8.51 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $7.94 Median $14.79 Typical High $36.31 | Professional | None | $7.94 | $14.79 | $36.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $18.62 Median $41.69 Typical High $173.78 | Facility | None | $18.62 | $41.69 | $173.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $15.49 | Professional | None | $12.30 | $15.49 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $16.98 Typical High $75.86 | Professional | None | $12.88 | $16.98 | $75.86 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $18.62 | Professional | None | $6.46 | $7.59 | $18.62 |
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 $3.55 Median $4.27 Typical High $6.46 | Professional | 52 · Reduced service | $3.55 | $4.27 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.70 Typical High $2.57 | Professional | 53 · Discontinued | $1.41 | $1.70 | $2.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $6.46 Typical High $9.77 | Professional | 54 · Surgery only | $5.37 | $6.46 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.29 Typical High $1.95 | Professional | 55 · Aftercare only | $1.07 | $1.29 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.85 Typical High $1.29 | Professional | 56 · Pre-op care only | $0.71 | $0.85 | $1.29 |
Where Illinois sits
The same service costs 4.5 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· 20th of 51
$12.30
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.