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 $54.95 Median $89.13 Typical High $154.88 | Facility | None | $54.95 | $89.13 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $117.49 | Professional | None | $58.88 | $81.28 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $109.65 | Professional | None | $81.28 | $95.50 | $109.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $1,148.15 | Facility | None | $194.98 | $316.23 | $1,148.15 |
BCBS Illinois Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $128.82 | Professional | None | $64.57 | $91.20 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $147.91 | Professional | None | $54.95 | $85.11 | $147.91 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $190.55 | Professional | None | $69.18 | $109.65 | $190.55 |
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 $79.43 Median $83.18 Typical High $128.82 | Professional | None | $79.43 | $83.18 | $128.82 |
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 $58.88 Median $89.13 Typical High $158.49 | Professional | None | $58.88 | $89.13 | $158.49 |
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 $29.51 Median $35.48 Typical High $44.67 | Professional | 52 · Reduced service | $29.51 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.72 Typical High $13.49 | Professional | 55 · Aftercare only | $8.91 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.08 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.89 | $7.08 | $8.91 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $97.72 Typical High $114.82 | Professional | 25 · Same-day visit | $89.13 | $97.72 | $114.82 |
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· 33rd of 51
$85.11
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.