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 $186.21 Median $398.11 Typical High $4,677.35 | Facility | None | $186.21 | $398.11 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $354.81 | Professional | None | $144.54 | $208.93 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $380.19 | Professional | None | $147.91 | $165.96 | $380.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,818.38 | Facility | None | $1,096.48 | $1,621.81 | $2,818.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $398.11 | Professional | None | $190.55 | $269.15 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,348.96 Typical High $1,659.59 | Facility | None | $478.63 | $1,348.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $389.05 | Professional | None | $162.18 | $245.47 | $389.05 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $501.19 | Professional | None | $186.21 | $302.00 | $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 $194.98 Median $208.93 Typical High $302.00 | Professional | None | $194.98 | $208.93 | $302.00 |
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 $676.08 Median $1,513.56 Typical High $4,265.80 | Facility | None | $676.08 | $1,513.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $407.38 | Professional | None | $154.88 | $239.88 | $407.38 |
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 $69.18 Median $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $69.18 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $27.54 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $104.71 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.80 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $128.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $97.72 | $128.82 | $144.54 |
Where Illinois sits
The same service costs 4.6 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
$263
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.