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 $8.51 Median $12.02 Typical High $36.31 | Facility | None | $8.51 | $12.02 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $30.90 | Professional | None | $10.00 | $10.00 | $30.90 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $22.91 Typical High $29.51 | Professional | None | $15.14 | $22.91 | $29.51 |
BCBS Illinois Setting Facility Modifier None Typical Low $26.30 Median $93.33 Typical High $147.91 | Facility | None | $26.30 | $93.33 | $147.91 |
BCBS Illinois Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $16.22 | Professional | None | $15.14 | $15.14 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $20.89 Typical High $42.66 | Professional | None | $8.71 | $20.89 | $42.66 |
Hally Health Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $51.29 | Professional | None | $19.95 | $28.18 | $51.29 |
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 $24.55 Median $25.12 Typical High $26.92 | Professional | None | $24.55 | $25.12 | $26.92 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $194.98 | Facility | None | $169.82 | $169.82 | $194.98 |
United Setting Professional Modifier None Typical Low $13.80 Median $22.91 Typical High $30.90 | Professional | None | $13.80 | $22.91 | $30.90 |
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 Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Illinois sits
The same service costs 5.4 times more in Vermont than in Kansas. 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
$20.89
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.