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 $3.55 Median $5.25 Typical High $12.88 | Facility | None | $3.55 | $5.25 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $6.61 | Professional | None | $3.55 | $3.89 | $6.61 |
Ambetter Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.89 | Professional | None | $2.14 | $2.14 | $3.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $5.75 Median $13.18 Typical High $53.70 | Facility | None | $5.75 | $13.18 | $53.70 |
BCBS Illinois Setting Professional Modifier None Typical Low $3.31 Median $3.47 Typical High $4.27 | Professional | None | $3.31 | $3.47 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $9.12 Typical High $17.78 | Facility | None | $4.79 | $9.12 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $5.01 Typical High $6.76 | Professional | None | $2.88 | $5.01 | $6.76 |
Hally Health Setting Professional Modifier None Typical Low $4.47 Median $7.24 Typical High $48.98 | Professional | None | $4.47 | $7.24 | $48.98 |
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 $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $5.37 | Professional | None | $2.34 | $2.34 | $5.37 |
United Setting Facility Modifier None Typical Low $4.27 Median $5.13 Typical High $10.47 | Facility | None | $4.27 | $5.13 | $10.47 |
United Setting Professional Modifier None Typical Low $2.14 Median $4.27 Typical High $5.13 | Professional | None | $2.14 | $4.27 | $5.13 |
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 Facility Modifier 52 · Reduced service Typical Low $1.78 Median $3.09 Typical High $6.46 | Facility | 52 · Reduced service | $1.78 | $3.09 | $6.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.71 Median $1.23 Typical High $2.57 | Facility | 53 · Discontinued | $0.71 | $1.23 | $2.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $1.78 Typical High $2.14 | Professional | 52 · Reduced service | $1.78 | $1.78 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.85 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.85 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $2.45 Median $4.90 Typical High $5.75 | Professional | QW · Waived lab test | $2.45 | $4.90 | $5.75 |
Where Illinois sits
The same service costs 14.8 times more in Minnesota 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· 39th of 51
$4.27
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.