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 $3.02 Median $5.25 Typical High $10.00 | Facility | None | $3.02 | $5.25 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $5.37 | Professional | None | $3.02 | $3.16 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $2.24 Median $4.90 Typical High $4.90 | Professional | None | $2.24 | $4.90 | $4.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $4.90 Median $10.72 Typical High $48.98 | Facility | None | $4.90 | $10.72 | $48.98 |
BCBS Illinois Setting Professional Modifier None Typical Low $2.82 Median $3.47 Typical High $3.63 | Professional | None | $2.82 | $3.47 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $8.51 Typical High $15.14 | Facility | None | $4.07 | $8.51 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $4.17 Typical High $6.61 | Professional | None | $1.86 | $4.17 | $6.61 |
Hally Health Setting Professional Modifier None Typical Low $3.89 Median $6.46 Typical High $35.48 | Professional | None | $3.89 | $6.46 | $35.48 |
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 $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Molina Setting Professional Modifier None Typical Low $2.04 Median $2.57 Typical High $4.57 | Professional | None | $2.04 | $2.57 | $4.57 |
United Setting Facility Modifier None Typical Low $3.63 Median $4.37 Typical High $9.33 | Facility | None | $3.63 | $4.37 | $9.33 |
United Setting Professional Modifier None Typical Low $1.55 Median $2.34 Typical High $3.98 | Professional | None | $1.55 | $2.34 | $3.98 |
4 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 Facility Modifier 52 · Reduced service Typical Low $1.51 Median $2.63 Typical High $5.50 | Facility | 52 · Reduced service | $1.51 | $2.63 | $5.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.60 Median $1.07 Typical High $2.24 | Facility | 53 · Discontinued | $0.60 | $1.07 | $2.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.51 Typical High $1.82 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.72 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.72 |
Where Illinois sits
The same service costs 10.2 times more in Vermont than in Maryland. 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· 31st of 51
$3.63
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.