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 $9.55 Median $13.80 Typical High $17.38 | Facility | None | $9.55 | $13.80 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $9.55 Typical High $12.02 | Professional | None | $1.51 | $9.55 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
BCBS Illinois Setting Facility Modifier None Typical Low $15.14 Median $21.88 Typical High $107.15 | Facility | None | $15.14 | $21.88 | $107.15 |
BCBS Illinois Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $6.46 Typical High $6.46 | Professional | None | $3.72 | $6.46 | $6.46 |
Hally Health Setting Professional Modifier None Typical Low $11.22 Median $19.95 Typical High $125.89 | Professional | None | $11.22 | $19.95 | $125.89 |
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 $11.22 Median $11.22 Typical High $15.49 | Professional | None | $11.22 | $11.22 | $15.49 |
United Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $15.49 | Facility | None | $13.18 | $13.18 | $15.49 |
United Setting Professional Modifier None Typical Low $9.33 Median $11.48 Typical High $19.95 | Professional | None | $9.33 | $11.48 | $19.95 |
5 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 $4.57 Median $4.57 Typical High $4.90 | Professional | 52 · Reduced service | $4.57 | $4.57 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.82 Typical High $1.95 | Professional | 53 · Discontinued | $1.82 | $1.82 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.38 Typical High $1.45 | Professional | 55 · Aftercare only | $1.38 | $1.38 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $0.98 |
Ambetter Setting Professional Modifier LR · Lab round trip Typical Low $4.79 Median $5.37 Typical High $5.50 | Professional | LR · Lab round trip | $4.79 | $5.37 | $5.50 |
Where Illinois sits
The same service costs 25.1 times more in Wyoming than in New Jersey. 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· 38th of 51
$7.94
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.