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 $6.31 Median $6.92 Typical High $13.80 | Facility | None | $6.31 | $6.92 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.92 Typical High $12.02 | Professional | None | $6.31 | $6.92 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | None | $8.51 | $9.33 | $9.33 |
BCBS Illinois Setting Facility Modifier None Typical Low $85.11 Median $218.78 Typical High $870.96 | Facility | None | $85.11 | $218.78 | $870.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Hally Health Setting Professional Modifier None Typical Low $29.51 Median $64.57 Typical High $97.72 | Professional | None | $29.51 | $64.57 | $97.72 |
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 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $63.10 | Professional | None | $43.65 | $56.23 | $63.10 |
United Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $20.42 | Professional | None | $7.08 | $8.32 | $20.42 |
4 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 $3.16 Median $3.47 Typical High $4.47 | Professional | 52 · Reduced service | $3.16 | $3.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.41 Typical High $1.82 | Professional | 53 · Discontinued | $1.26 | $1.41 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.93 Median $1.05 Typical High $1.35 | Professional | 55 · Aftercare only | $0.93 | $1.05 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.71 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.63 | $0.71 | $0.89 |
Where Illinois sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 5th of 51
$20.89
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.