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 $50.12 Median $57.54 Typical High $70.79 | Facility | None | $50.12 | $57.54 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $93.33 | Professional | None | $47.86 | $61.66 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $91.20 | Professional | None | $60.26 | $75.86 | $91.20 |
BCBS Illinois Setting Facility Modifier None Typical Low $131.83 Median $263.03 Typical High $1,071.52 | Facility | None | $131.83 | $263.03 | $1,071.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | None | $85.11 | $85.11 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $123.03 | Professional | None | $54.95 | $83.18 | $123.03 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $223.87 | Professional | None | $75.86 | $109.65 | $223.87 |
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 $89.13 Median $95.50 Typical High $104.71 | Professional | None | $89.13 | $95.50 | $104.71 |
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 Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $131.83 | Professional | None | $63.10 | $79.43 | $131.83 |
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 Professional Modifier 52 · Reduced service Typical Low $28.18 Median $33.88 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.00 Typical High $10.47 | Professional | 55 · Aftercare only | $8.32 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.76 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $6.76 | $6.92 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $74.13 Median $87.10 Typical High $102.33 | Professional | 25 · Same-day visit | $74.13 | $87.10 | $102.33 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $79.43 Median $83.18 Typical High $100.00 | Professional | GC · Resident with teaching physician | $79.43 | $83.18 | $100.00 |
Where Illinois sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 27th of 51
$77.62
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.