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 $28.84 Median $32.36 Typical High $120.23 | Facility | None | $28.84 | $32.36 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | None | $32.36 | $32.36 | $37.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $47.86 Median $112.20 Typical High $257.04 | Facility | None | $47.86 | $112.20 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $64.57 Typical High $77.62 | Facility | None | $43.65 | $64.57 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Hally Health Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $75.86 | Professional | None | $30.90 | $39.81 | $75.86 |
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 $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $72.44 | Facility | None | $32.36 | $32.36 | $72.44 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | None | $31.62 | $31.62 | $33.88 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | JZ · No drug discarded | $42.66 | $42.66 | $42.66 |
Where Illinois sits
The same service costs 2.0 times more in Alaska than in Oklahoma. 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· 22nd of 51
$33.11
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.