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 $36.31 Median $51.29 Typical High $74.13 | Facility | None | $36.31 | $51.29 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | None | $36.31 | $36.31 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $18.62 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.72 |
BCBS Illinois Setting Facility Modifier None Typical Low $93.33 Median $131.83 Typical High $302.00 | Facility | None | $93.33 | $131.83 | $302.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $48.98 | Professional | None | $43.65 | $46.77 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $74.13 Typical High $91.20 | Facility | None | $48.98 | $74.13 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | None | $36.31 | $36.31 | $38.02 |
Hally Health Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $93.33 | Professional | None | $36.31 | $42.66 | $93.33 |
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 $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $53.70 | Professional | None | $36.31 | $45.71 | $53.70 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $83.18 | Facility | None | $36.31 | $36.31 | $83.18 |
United Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $41.69 | Professional | None | $36.31 | $39.81 | $41.69 |
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 JW · Drug discarded + JZ · No drug discarded Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | JW · Drug discarded + JZ · No drug discarded | $36.31 | $36.31 | $36.31 |
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· 33rd of 51
$36.31
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.