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 $38.02 Median $43.65 Typical High $158.49 | Facility | None | $38.02 | $43.65 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $67.61 | Professional | None | $43.65 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
BCBS Illinois Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $323.59 | Facility | None | $75.86 | $151.36 | $323.59 |
BCBS Illinois Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | None | $45.71 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $87.10 Typical High $109.65 | Facility | None | $61.66 | $87.10 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | None | $43.65 | $43.65 | $45.71 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $100.00 | Professional | None | $40.74 | $48.98 | $100.00 |
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 $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $61.66 | Professional | None | $42.66 | $52.48 | $61.66 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $97.72 | Facility | None | $43.65 | $43.65 | $97.72 |
United Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $47.86 | Professional | None | $42.66 | $46.77 | $47.86 |
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 Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | JW · Drug discarded | $42.66 | $42.66 | $42.66 |
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· 32nd of 51
$43.65
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.