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 $117.49 Median $1,288.25 Typical High $5,623.41 | Facility | None | $117.49 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $218.78 | Professional | None | $93.33 | $131.83 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $102.33 Typical High $245.47 | Professional | None | $41.69 | $102.33 | $245.47 |
BCBS Illinois Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $1,318.26 | Facility | None | $158.49 | $257.04 | $1,318.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $239.88 | Professional | None | $114.82 | $165.96 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $213.80 Typical High $512.86 | Facility | None | $147.91 | $213.80 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $245.47 | Professional | None | $104.71 | $147.91 | $245.47 |
Hally Health Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $323.59 | Professional | None | $117.49 | $186.21 | $323.59 |
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 $128.82 Median $131.83 Typical High $186.21 | Professional | None | $128.82 | $131.83 | $186.21 |
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 $97.72 Median $151.36 Typical High $251.19 | Professional | None | $97.72 | $151.36 | $251.19 |
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 $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $44.67 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $17.78 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $66.07 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.75 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.91 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $81.28 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $61.66 | $81.28 | $91.20 |
Where Illinois sits
The same service costs 4.1 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.