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 $1.35 Median $1.62 Typical High $2.95 | Facility | None | $1.35 | $1.62 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.62 Typical High $2.45 | Professional | None | $1.35 | $1.62 | $2.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.81 Typical High $1.23 | Professional | 52 · Reduced service | $0.68 | $0.81 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.32 Typical High $0.49 | Professional | 53 · Discontinued | $0.27 | $0.32 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.24 Typical High $0.37 | Professional | 55 · Aftercare only | $0.20 | $0.24 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.16 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.13 | $0.16 | $0.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $3.39 Median $6.31 Typical High $25.12 | Facility | None | $3.39 | $6.31 | $25.12 |
BCBS Illinois Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $2.04 | Professional | None | $1.48 | $1.48 | $2.04 |
Hally Health Setting Professional Modifier None Typical Low $2.63 Median $4.07 Typical High $7.41 | Professional | None | $2.63 | $4.07 | $7.41 |
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 $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Molina Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.45 Typical High $3.47 | Professional | None | $1.15 | $1.45 | $3.47 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | KX · Policy requirements met | $2.04 | $2.04 | $2.04 |
Where Illinois sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 21st of 51
$2.19
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.