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 $23.99 Median $28.84 Typical High $52.48 | Facility | None | $23.99 | $28.84 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $50.12 | Professional | None | $28.84 | $28.84 | $50.12 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $63.10 Median $141.25 Typical High $588.84 | Facility | None | $63.10 | $141.25 | $588.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $52.48 | Professional | None | $41.69 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Hally Health Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $154.88 | Professional | None | $43.65 | $58.88 | $154.88 |
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 $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $63.10 | Professional | None | $21.88 | $25.70 | $63.10 |
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 $12.02 Median $14.45 Typical High $21.88 | Professional | 52 · Reduced service | $12.02 | $14.45 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.75 Typical High $8.71 | Professional | 53 · Discontinued | $4.79 | $5.75 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $21.88 Typical High $33.11 | Professional | 54 · Surgery only | $18.20 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.37 Typical High $6.61 | Professional | 55 · Aftercare only | $3.63 | $4.37 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.88 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.40 | $2.88 | $4.37 |
Where Illinois sits
The same service costs 2.6 times more in Hawaii 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· 16th of 51
$41.69
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.