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 $75.86 Median $75.86 Typical High $112.20 | Facility | None | $75.86 | $75.86 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $91.20 | Professional | None | $72.44 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $38.02 Typical High $45.71 | Professional | 52 · Reduced service | $36.31 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $14.45 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $10.72 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $9.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $134.90 Median $162.18 Typical High $2,089.30 | Facility | None | $134.90 | $162.18 | $2,089.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $154.88 | Professional | None | $74.13 | $102.33 | $154.88 |
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 |
United Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $158.49 | Facility | None | $112.20 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $61.66 | Professional | None | $46.77 | $52.48 | $61.66 |
3 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Illinois sits
The same service costs 2.6 times more in Hawaii than in Indiana. 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· 28th of 51
$75.86
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.