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 $177.83 Median $331.13 Typical High $4,677.35 | Facility | None | $177.83 | $331.13 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $331.13 | Professional | None | $154.88 | $194.98 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $269.15 | Professional | None | $169.82 | $204.17 | $269.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $1,995.26 | Facility | None | $194.98 | $316.23 | $1,995.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | None | $213.80 | $263.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $263.03 Typical High $524.81 | Facility | None | $186.21 | $263.03 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $380.19 | Professional | None | $181.97 | $263.03 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $489.78 | Professional | None | $194.98 | $302.00 | $489.78 |
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 $218.78 Median $229.09 Typical High $288.40 | Professional | None | $218.78 | $229.09 | $288.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $398.11 | Professional | None | $162.18 | $239.88 | $398.11 |
6 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 $75.86 Median $89.13 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $38.90 | Professional | 53 · Discontinued | $30.90 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $131.83 Typical High $147.91 | Professional | 54 · Surgery only | $114.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.30 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.78 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $123.03 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $107.15 | $123.03 | $138.04 |
Where Illinois sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 19th of 51
$257
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.