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 $75.86 Median $102.33 Typical High $194.98 | Facility | None | $75.86 | $102.33 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $158.49 | Professional | None | $77.62 | $109.65 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $162.18 | Professional | None | $79.43 | $125.89 | $162.18 |
BCBS Illinois Setting Facility Modifier None Typical Low $269.15 Median $446.68 Typical High $1,584.89 | Facility | None | $269.15 | $446.68 | $1,584.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $165.96 | Professional | None | $91.20 | $123.03 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $194.98 | Professional | None | $81.28 | $120.23 | $194.98 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $275.42 | Professional | None | $100.00 | $147.91 | $275.42 |
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 $112.20 Median $117.49 Typical High $173.78 | Professional | None | $112.20 | $117.49 | $173.78 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | None | $64.57 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $208.93 | Professional | None | $87.10 | $125.89 | $208.93 |
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 $40.74 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $14.13 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.55 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $9.55 | $11.75 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $79.43 Median $125.89 Typical High $169.82 | Professional | 25 · Same-day visit | $79.43 | $125.89 | $169.82 |
Where Illinois sits
The same service costs 2.7 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· 30th of 51
$117
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.