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 $69.18 Median $102.33 Typical High $177.83 | Facility | None | $69.18 | $102.33 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $144.54 | Professional | None | $70.79 | $100.00 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $138.04 | Professional | None | $72.44 | $112.20 | $138.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $1,479.11 | Facility | None | $234.42 | $398.11 | $1,479.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $151.36 | Professional | None | $83.18 | $112.20 | $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 $104.71 Typical High $177.83 | Professional | None | $72.44 | $104.71 | $177.83 |
Hally Health Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $251.19 | Professional | None | $91.20 | $131.83 | $251.19 |
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 $102.33 Median $107.15 Typical High $154.88 | Professional | None | $102.33 | $107.15 | $154.88 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | None | $41.69 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $186.21 | Professional | None | $75.86 | $109.65 | $186.21 |
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 $37.15 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $37.15 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.41 | $8.51 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $114.82 Typical High $151.36 | Professional | 25 · Same-day visit | $97.72 | $114.82 | $151.36 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | GC · Resident with teaching physician | $83.18 | $83.18 | $83.18 |
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
$107
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.