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 $12.02 Median $14.45 Typical High $28.18 | Facility | None | $12.02 | $14.45 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $24.55 | Professional | None | $14.45 | $14.45 | $24.55 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
BCBS Illinois Setting Facility Modifier None Typical Low $32.36 Median $70.79 Typical High $295.12 | Facility | None | $32.36 | $70.79 | $295.12 |
BCBS Illinois Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $26.30 | Professional | None | $20.89 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Hally Health Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $74.13 | Professional | None | $21.88 | $29.51 | $74.13 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $30.90 | Professional | None | $10.96 | $12.88 | $30.90 |
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 $6.03 Median $7.24 Typical High $10.96 | Professional | 52 · Reduced service | $6.03 | $7.24 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.88 Typical High $4.37 | Professional | 53 · Discontinued | $2.40 | $2.88 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $10.72 Typical High $16.60 | Professional | 54 · Surgery only | $8.91 | $10.72 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.19 Typical High $3.31 | Professional | 55 · Aftercare only | $1.82 | $2.19 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.45 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.20 | $1.45 | $2.19 |
Where Illinois sits
The same service costs 3.5 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· 17th of 51
$20.89
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.