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 $60.26 Median $87.10 Typical High $162.18 | Facility | None | $60.26 | $87.10 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $138.04 | Professional | None | $64.57 | $87.10 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $128.82 | Professional | None | $89.13 | $100.00 | $128.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $1,258.93 | Facility | None | $229.09 | $371.54 | $1,258.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $141.25 | Professional | None | $70.79 | $104.71 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $165.96 | Professional | None | $63.10 | $104.71 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $223.87 | Professional | None | $77.62 | $120.23 | $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 $87.10 Median $91.20 Typical High $144.54 | Professional | None | $87.10 | $91.20 | $144.54 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | None | $31.62 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $173.78 | Professional | None | $67.61 | $102.33 | $173.78 |
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 $32.36 Median $39.81 Typical High $50.12 | Professional | 52 · Reduced service | $32.36 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.02 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.94 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $7.94 | $10.00 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 25 · Same-day visit | $104.71 | $104.71 | $125.89 |
Where Illinois sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 29th of 51
$100
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.