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 $67.61 Median $104.71 Typical High $173.78 | Facility | None | $67.61 | $104.71 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $141.25 | Professional | None | $70.79 | $97.72 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $131.83 | Professional | None | $60.26 | $112.20 | $131.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $1,412.54 | Facility | None | $234.42 | $389.05 | $1,412.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $151.36 | Professional | None | $81.28 | $109.65 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $173.78 | Professional | None | $72.44 | $102.33 | $173.78 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $223.87 | Professional | None | $87.10 | $128.82 | $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 $100.00 Median $102.33 Typical High $151.36 | Professional | None | $100.00 | $102.33 | $151.36 |
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 $75.86 Median $107.15 Typical High $181.97 | Professional | None | $75.86 | $107.15 | $181.97 |
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 $36.31 Median $41.69 Typical High $52.48 | Professional | 52 · Reduced service | $36.31 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.32 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.24 | $8.32 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $60.26 Median $125.89 Typical High $134.90 | Professional | 25 · Same-day visit | $60.26 | $125.89 | $134.90 |
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· 33rd of 51
$105
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.