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 $93.33 Median $120.23 Typical High $169.82 | Facility | None | $93.33 | $120.23 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $186.21 | Professional | None | $95.50 | $131.83 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $177.83 | Professional | None | $107.15 | $147.91 | $177.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $316.23 Median $537.03 Typical High $1,949.84 | Facility | None | $316.23 | $537.03 | $1,949.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $194.98 | Professional | None | $109.65 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $229.09 | Professional | None | $100.00 | $147.91 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $323.59 | Professional | None | $120.23 | $169.82 | $323.59 |
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 $138.04 Median $141.25 Typical High $199.53 | Professional | None | $138.04 | $141.25 | $199.53 |
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 $104.71 Median $147.91 Typical High $239.88 | Professional | None | $104.71 | $147.91 | $239.88 |
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 $50.12 Median $56.23 Typical High $67.61 | Professional | 52 · Reduced service | $50.12 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.22 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.00 | $11.22 | $13.49 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $147.91 Typical High $186.21 | Professional | 25 · Same-day visit | $95.50 | $147.91 | $186.21 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | GC · Resident with teaching physician | $162.18 | $162.18 | $177.83 |
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
$138
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.