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 $288.40 Median $1,698.24 Typical High $5,623.41 | Facility | None | $288.40 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $489.78 | Professional | None | $190.55 | $275.42 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $2,344.23 | Facility | None | $588.84 | $891.25 | $2,344.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $537.03 | Professional | None | $223.87 | $338.84 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,047.13 | Facility | None | $524.81 | $724.44 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $524.81 | Professional | None | $199.53 | $309.03 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $707.95 | Professional | None | $234.42 | $407.38 | $707.95 |
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 $251.19 Median $263.03 Typical High $416.87 | Professional | None | $251.19 | $263.03 | $416.87 |
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 $204.17 Median $331.13 Typical High $562.34 | Professional | None | $204.17 | $331.13 | $562.34 |
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 $91.20 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $91.20 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $194.98 Typical High $213.80 | Professional | 54 · Surgery only | $134.90 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.90 Typical High $42.66 | Professional | 55 · Aftercare only | $26.92 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $181.97 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $125.89 | $181.97 | $199.53 |
Where Illinois sits
The same service costs 3.6 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· 23rd of 51
$339
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.