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 $1.12 Median $1.95 Typical High $4.07 | Facility | None | $1.12 | $1.95 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.58 | Professional | None | $1.12 | $1.12 | $1.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $2.63 Median $4.47 Typical High $8.91 | Facility | None | $2.63 | $4.47 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $2.24 Typical High $2.69 | Facility | None | $1.51 | $2.24 | $2.69 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Hally Health Setting Professional Modifier None Typical Low $1.12 Median $1.45 Typical High $4.68 | Professional | None | $1.12 | $1.45 | $4.68 |
Hally Health Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
United Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $2.51 | Facility | None | $1.12 | $1.12 | $2.51 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.17 | Professional | None | $1.10 | $1.10 | $1.17 |
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 $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | JZ · No drug discarded | $1.48 | $1.48 | $1.48 |
Where Illinois sits
The same service costs 2.2 times more in Wyoming than in Rhode Island. 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· 47th of 51
$1.12
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.