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 $165.96 Median $380.19 Typical High $4,677.35 | Facility | None | $165.96 | $380.19 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $309.03 | Professional | None | $131.83 | $177.83 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $109.65 Typical High $181.97 | Professional | None | $57.54 | $109.65 | $181.97 |
BCBS Illinois Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $1,584.89 | Facility | None | $194.98 | $316.23 | $1,584.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $331.13 | Professional | None | $158.49 | $229.09 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $263.03 Typical High $512.86 | Facility | None | $186.21 | $263.03 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $331.13 | Professional | None | $144.54 | $213.80 | $331.13 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $446.68 | Professional | None | $162.18 | $257.04 | $446.68 |
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 $177.83 Median $181.97 Typical High $257.04 | Professional | None | $177.83 | $181.97 | $257.04 |
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 $138.04 Median $208.93 Typical High $346.74 | Professional | None | $138.04 | $208.93 | $346.74 |
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 $61.66 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $93.33 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $19.05 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $123.03 |
Where Illinois sits
The same service costs 3.9 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· 19th of 51
$224
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.