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 $10.96 Median $13.18 Typical High $23.99 | Facility | None | $10.96 | $13.18 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $21.88 | Professional | None | $12.88 | $13.18 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $19.95 | Professional | None | $13.80 | $13.80 | $19.95 |
BCBS Illinois Setting Facility Modifier None Typical Low $28.84 Median $64.57 Typical High $269.15 | Facility | None | $28.84 | $64.57 | $269.15 |
BCBS Illinois Setting Professional Modifier None Typical Low $19.05 Median $23.99 Typical High $23.99 | Professional | None | $19.05 | $23.99 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Hally Health Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $104.71 | Professional | None | $19.95 | $26.92 | $104.71 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $28.18 | Professional | None | $9.77 | $11.75 | $28.18 |
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 $5.50 Median $6.61 Typical High $10.00 | Professional | 52 · Reduced service | $5.50 | $6.61 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.63 Typical High $3.98 | Professional | 53 · Discontinued | $2.19 | $2.63 | $3.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.13 Median $9.77 Typical High $15.14 | Professional | 54 · Surgery only | $8.13 | $9.77 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.95 Typical High $3.02 | Professional | 55 · Aftercare only | $1.62 | $1.95 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.32 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.10 | $1.32 | $2.00 |
Where Illinois sits
The same service costs 2.9 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
$19.05
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.