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 $5.50 Median $6.61 Typical High $12.02 | Facility | None | $5.50 | $6.61 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $6.61 Typical High $10.96 | Professional | None | $5.75 | $6.61 | $10.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $13.80 Median $22.91 Typical High $131.83 | Facility | None | $13.80 | $22.91 | $131.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $9.55 Median $12.02 Typical High $12.02 | Professional | None | $9.55 | $12.02 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Hally Health Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $39.81 | Professional | None | $10.00 | $13.49 | $39.81 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $14.13 | Professional | None | $4.90 | $5.75 | $14.13 |
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 $2.69 Median $3.31 Typical High $5.01 | Professional | 52 · Reduced service | $2.69 | $3.31 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.32 Typical High $2.00 | Professional | 53 · Discontinued | $1.10 | $1.32 | $2.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.07 Median $4.90 Typical High $7.59 | Professional | 54 · Surgery only | $4.07 | $4.90 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.98 Typical High $1.51 | Professional | 55 · Aftercare only | $0.81 | $0.98 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.66 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.54 | $0.66 | $1.00 |
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
$9.55
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.