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 $125.89 Median $288.40 Typical High $4,168.69 | Facility | None | $125.89 | $288.40 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $263.03 | Professional | None | $100.00 | $154.88 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $234.42 | Professional | None | $81.28 | $120.23 | $234.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $1,318.26 | Facility | None | $177.83 | $288.40 | $1,318.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $295.12 | Professional | None | $125.89 | $186.21 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $512.86 | Facility | None | $169.82 | $239.88 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $281.84 | Professional | None | $114.82 | $173.78 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $389.05 | Professional | None | $131.83 | $223.87 | $389.05 |
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 $138.04 Median $144.54 Typical High $229.09 | Professional | None | $138.04 | $144.54 | $229.09 |
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 $3,019.95 | Facility | None | $446.68 | $1,047.13 | $3,019.95 |
United Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $302.00 | Professional | None | $109.65 | $177.83 | $302.00 |
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 $48.98 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $48.98 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $19.50 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $107.15 Typical High $117.49 | Professional | 54 · Surgery only | $74.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.38 Typical High $23.44 | Professional | 55 · Aftercare only | $14.79 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.77 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $100.00 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $69.18 | $100.00 | $109.65 |
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· 22nd of 51
$182
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.