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 $57.54 Median $79.43 Typical High $204.17 | Facility | None | $57.54 | $79.43 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $89.13 | Professional | None | $57.54 | $57.54 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
BCBS Illinois Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $436.52 | Facility | None | $134.90 | $190.55 | $436.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | None | $58.88 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $141.25 | Facility | None | $79.43 | $114.82 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
Hally Health Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $131.83 | Professional | None | $53.70 | $70.79 | $131.83 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $128.82 | Facility | None | $57.54 | $57.54 | $128.82 |
United Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $63.10 | Professional | None | $54.95 | $60.26 | $63.10 |
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 JZ · No drug discarded Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | JZ · No drug discarded | $57.54 | $57.54 | $57.54 |
Where Illinois sits
Rates are fairly even across states for this service. 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· 39th of 51
$57.54
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.