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 $3.72 Median $5.50 Typical High $12.30 | Facility | None | $3.72 | $5.50 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $4.07 Typical High $7.24 | Professional | None | $3.72 | $4.07 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $4.47 | Professional | None | $2.04 | $2.24 | $4.47 |
BCBS Illinois Setting Facility Modifier None Typical Low $6.17 Median $13.18 Typical High $56.23 | Facility | None | $6.17 | $13.18 | $56.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.47 | Professional | None | $3.47 | $3.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $10.23 Typical High $19.05 | Facility | None | $5.13 | $10.23 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $5.37 Typical High $7.76 | Professional | None | $2.40 | $5.37 | $7.76 |
Hally Health Setting Professional Modifier None Typical Low $4.79 Median $7.94 Typical High $47.86 | Professional | None | $4.79 | $7.94 | $47.86 |
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 $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Molina Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $5.62 | Professional | None | $2.51 | $2.51 | $5.62 |
United Setting Facility Modifier None Typical Low $4.47 Median $5.37 Typical High $10.47 | Facility | None | $4.47 | $5.37 | $10.47 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.88 Typical High $4.90 | Professional | None | $1.91 | $2.88 | $4.90 |
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 $1.86 Median $3.31 Typical High $6.92 | Facility | 52 · Reduced service | $1.86 | $3.31 | $6.92 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.74 Median $1.32 Typical High $2.75 | Facility | 53 · Discontinued | $0.74 | $1.32 | $2.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.86 Median $1.86 Typical High $2.24 | Professional | 52 · Reduced service | $1.86 | $1.86 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.74 Typical High $0.89 | Professional | 53 · Discontinued | $0.74 | $0.74 | $0.89 |
Where Illinois sits
The same service costs 15.8 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· 34th of 51
$4.47
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.