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 $4.68 Median $7.94 Typical High $16.22 | Facility | None | $4.68 | $7.94 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $7.24 | Professional | None | $4.47 | $4.68 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
BCBS Illinois Setting Facility Modifier None Typical Low $10.23 Median $29.51 Typical High $85.11 | Facility | None | $10.23 | $29.51 | $85.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $3.47 Median $4.17 Typical High $4.17 | Professional | None | $3.47 | $4.17 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $12.30 Typical High $21.88 | Facility | None | $5.89 | $12.30 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $6.46 Typical High $9.55 | Professional | None | $2.69 | $6.46 | $9.55 |
Hally Health Setting Professional Modifier None Typical Low $5.62 Median $9.33 Typical High $56.23 | Professional | None | $5.62 | $9.33 | $56.23 |
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 $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Molina Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $6.76 | Professional | None | $3.80 | $3.80 | $6.76 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $158.49 | Facility | None | $141.25 | $141.25 | $158.49 |
United Setting Professional Modifier None Typical Low $2.24 Median $4.17 Typical High $5.75 | Professional | None | $2.24 | $4.17 | $5.75 |
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 $2.19 Median $3.89 Typical High $8.13 | Facility | 52 · Reduced service | $2.19 | $3.89 | $8.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.87 Median $1.55 Typical High $3.24 | Facility | 53 · Discontinued | $0.87 | $1.55 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $2.19 Typical High $2.69 | Professional | 52 · Reduced service | $2.19 | $2.19 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $1.07 | Professional | 53 · Discontinued | $0.87 | $0.87 | $1.07 |
Where Illinois sits
The same service costs 11.2 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· 50th of 51
$4.17
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.