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 $120.23 Median $446.68 Typical High $5,128.61 | Facility | None | $120.23 | $446.68 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $251.19 | Professional | None | $95.50 | $147.91 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $151.36 Typical High $162.18 | Professional | None | $61.66 | $151.36 | $162.18 |
BCBS Illinois Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $1,318.26 | Facility | None | $162.18 | $257.04 | $1,318.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $275.42 | Professional | None | $120.23 | $173.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $512.86 | Facility | None | $151.36 | $213.80 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $269.15 | Professional | None | $112.20 | $162.18 | $269.15 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $363.08 | Professional | None | $125.89 | $208.93 | $363.08 |
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 $131.83 Median $134.90 Typical High $208.93 | Professional | None | $131.83 | $134.90 | $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 $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 $107.15 Median $169.82 Typical High $288.40 | Professional | None | $107.15 | $169.82 | $288.40 |
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 $46.77 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $46.77 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $29.51 | Professional | 53 · Discontinued | $18.62 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $100.00 Typical High $109.65 | Professional | 54 · Surgery only | $69.18 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $93.33 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $64.57 | $93.33 | $102.33 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 23rd of 51
$174
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.