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 $1.38 Median $1.95 Typical High $4.27 | Facility | None | $1.38 | $1.95 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.34 | Professional | None | $1.38 | $1.38 | $2.34 |
BCBS Illinois Setting Facility Modifier None Typical Low $1.78 Median $3.47 Typical High $8.91 | Facility | None | $1.78 | $3.47 | $8.91 |
BCBS Illinois Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.35 | Professional | None | $1.17 | $1.17 | $1.35 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $2.75 Typical High $3.31 | Facility | None | $1.86 | $2.75 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Hally Health Setting Professional Modifier None Typical Low $1.07 Median $1.32 Typical High $2.00 | Professional | None | $1.07 | $1.32 | $2.00 |
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 Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.23 | Professional | None | $1.15 | $1.15 | $1.23 |
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 $0.71 Median $0.71 Typical High $0.71 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | JZ · No drug discarded | $1.38 | $1.38 | $1.38 |
Where Illinois sits
The same service costs 5.9 times more in Vermont 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· 26th of 51
$1.38
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.