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 $0.91 Median $0.91 Typical High $0.95 | Facility | None | $0.91 | $0.91 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $0.95 | Professional | None | $0.91 | $0.91 | $0.95 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
BCBS Illinois Setting Facility Modifier None Typical Low $1.51 Median $12.88 Typical High $87.10 | Facility | None | $1.51 | $12.88 | $87.10 |
BCBS Illinois Setting Professional Modifier None Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | None | $6.46 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.85 Typical High $0.85 | Professional | None | $0.38 | $0.85 | $0.85 |
Hally Health Setting Professional Modifier None Typical Low $0.65 Median $1.48 Typical High $151.36 | Professional | None | $0.65 | $1.48 | $151.36 |
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 $1.55 Median $1.55 Typical High $1.55 | Professional | None | $1.55 | $1.55 | $1.55 |
United Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Facility | None | $1.32 | $1.32 | $1.55 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.15 Typical High $2.00 | Professional | None | $0.93 | $1.15 | $2.00 |
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 $0.46 Median $0.46 Typical High $0.48 | Professional | 52 · Reduced service | $0.46 | $0.46 | $0.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.18 Median $0.18 Typical High $0.19 | Professional | 53 · Discontinued | $0.18 | $0.18 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.10 |
Where Illinois sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 2nd of 51
$6.46
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.