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 $194.98 Median $549.54 Typical High $4,677.35 | Facility | None | $194.98 | $549.54 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $371.54 | Professional | None | $158.49 | $208.93 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $213.80 | Professional | None | $120.23 | $154.88 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $2,818.38 | Facility | None | $218.78 | $354.81 | $2,818.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $398.11 | Professional | None | $194.98 | $275.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $512.86 | Facility | None | $204.17 | $295.12 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $389.05 | Professional | None | $181.97 | $257.04 | $389.05 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $524.81 | Professional | None | $204.17 | $309.03 | $524.81 |
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 $213.80 Median $223.87 Typical High $309.03 | Professional | None | $213.80 | $223.87 | $309.03 |
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 $3,890.45 | Facility | None | $446.68 | $1,047.13 | $3,890.45 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $416.87 | Professional | None | $169.82 | $251.19 | $416.87 |
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 $75.86 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $75.86 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $30.20 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $141.25 Typical High $158.49 | Professional | 54 · Surgery only | $114.82 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $22.91 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.14 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $131.83 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $107.15 | $131.83 | $147.91 |
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· 20th of 51
$269
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.