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 $112.20 Median $223.87 Typical High $4,168.69 | Facility | None | $112.20 | $223.87 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $208.93 | Professional | None | $87.10 | $120.23 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $169.82 | Professional | None | $97.72 | $117.49 | $169.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $131.83 Median $208.93 Typical High $1,047.13 | Facility | None | $131.83 | $208.93 | $1,047.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $223.87 | Professional | None | $112.20 | $154.88 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $162.18 Typical High $251.19 | Facility | None | $89.13 | $162.18 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $229.09 | Professional | None | $91.20 | $141.25 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $281.84 | Professional | None | $107.15 | $169.82 | $281.84 |
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 $114.82 Median $120.23 Typical High $173.78 | Professional | None | $114.82 | $120.23 | $173.78 |
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 $91.20 Median $141.25 Typical High $234.42 | Professional | None | $91.20 | $141.25 | $234.42 |
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 $40.74 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $40.74 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $81.28 Typical High $89.13 | Professional | 54 · Surgery only | $60.26 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.13 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $75.86 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $56.23 | $75.86 | $83.18 |
Where Illinois sits
The same service costs 3.8 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· 19th of 51
$151
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.