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 $97.72 Median $758.58 Typical High $5,128.61 | Facility | None | $97.72 | $758.58 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $234.42 | Professional | None | $91.20 | $141.25 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $173.78 | Professional | None | $72.44 | $123.03 | $173.78 |
BCBS Illinois Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $1,148.15 | Facility | None | $165.96 | $263.03 | $1,148.15 |
BCBS Illinois Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $263.03 | Professional | None | $114.82 | $165.96 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $512.86 | Facility | None | $154.88 | $218.78 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $257.04 | Professional | None | $102.33 | $158.49 | $257.04 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $316.23 | Professional | None | $120.23 | $199.53 | $316.23 |
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 $208.93 | Professional | None | $125.89 | $131.83 | $208.93 |
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 $100.00 Median $158.49 Typical High $275.42 | Professional | None | $100.00 | $158.49 | $275.42 |
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 $44.67 Median $63.10 Typical High $72.44 | Professional | 52 · Reduced service | $44.67 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $107.15 | Professional | 54 · Surgery only | $67.61 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $13.49 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $89.13 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $63.10 | $89.13 | $100.00 |
Where Illinois sits
The same service costs 3.7 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· 20th of 51
$166
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.