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 $2.88 Median $4.90 Typical High $5.62 | Facility | None | $2.88 | $4.90 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $4.47 | Professional | None | $2.88 | $2.88 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.44 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $9.33 Median $13.80 Typical High $25.70 | Facility | None | $9.33 | $13.80 | $25.70 |
BCBS Illinois Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.01 | Professional | None | $4.37 | $4.37 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $5.75 Typical High $7.41 | Facility | None | $4.07 | $5.75 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.02 | Professional | None | $2.88 | $2.88 | $3.02 |
Hally Health Setting Professional Modifier None Typical Low $2.82 Median $3.47 Typical High $15.14 | Professional | None | $2.82 | $3.47 | $15.14 |
Hally Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Molina Setting Professional Modifier None Typical Low $3.24 Median $4.07 Typical High $4.79 | Professional | None | $3.24 | $4.07 | $4.79 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.37 | Professional | None | $3.24 | $3.24 | $4.37 |
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 $2.95 Median $2.95 Typical High $2.95 | Professional | JW · Drug discarded + JZ · No drug discarded | $2.95 | $2.95 | $2.95 |
Where Illinois sits
The same service costs 3.1 times more in Wyoming than in Delaware. 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· 48th of 51
$2.88
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.