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 $16.22 Median $27.54 Typical High $28.18 | Facility | None | $16.22 | $27.54 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $20.89 | Professional | None | $16.22 | $16.22 | $20.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $48.98 Median $100.00 Typical High $128.82 | Facility | None | $48.98 | $100.00 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $32.36 Typical High $41.69 | Facility | None | $21.88 | $32.36 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Hally Health Setting Professional Modifier None Typical Low $27.54 Median $52.48 Typical High $112.20 | Professional | None | $27.54 | $52.48 | $112.20 |
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 $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $36.31 | Facility | None | $16.22 | $16.22 | $36.31 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.45 Typical High $15.49 | Professional | None | $13.80 | $14.45 | $15.49 |
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 $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.45 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | JZ · No drug discarded | $21.88 | $21.88 | $21.88 |
Where Illinois sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 18th of 51
$17.78
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.