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 $128.82 Median $354.81 Typical High $4,677.35 | Facility | None | $128.82 | $354.81 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $371.54 | Professional | None | $89.13 | $169.82 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $239.88 Typical High $323.59 | Professional | None | $89.13 | $239.88 | $323.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $1,318.26 | Facility | None | $338.84 | $524.81 | $1,318.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $128.82 Median $269.15 Typical High $446.68 | Professional | None | $128.82 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $416.87 Typical High $537.03 | Facility | None | $229.09 | $416.87 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $416.87 | Professional | None | $107.15 | $181.97 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $117.49 Median $288.40 Typical High $501.19 | Professional | None | $117.49 | $288.40 | $501.19 |
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 $125.89 Median $131.83 Typical High $323.59 | Professional | None | $125.89 | $131.83 | $323.59 |
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 $446.68 Median $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $371.54 | Professional | None | $97.72 | $186.21 | $371.54 |
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 $44.67 Median $91.20 Typical High $114.82 | Professional | 52 · Reduced service | $44.67 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $37.15 Typical High $45.71 | Professional | 53 · Discontinued | $17.78 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $66.07 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $27.54 Typical High $34.67 | Professional | 55 · Aftercare only | $13.18 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $18.62 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.91 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $128.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $61.66 | $128.82 | $162.18 |
Where Illinois sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 22nd of 51
$219
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.