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 $275.42 Median $1,288.25 Typical High $5,623.41 | Facility | None | $275.42 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $478.63 | Professional | None | $181.97 | $269.15 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $2,884.03 | Facility | None | $275.42 | $446.68 | $2,884.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $512.86 | Professional | None | $218.78 | $323.59 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $346.74 Typical High $501.19 | Facility | None | $186.21 | $346.74 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $501.19 | Professional | None | $199.53 | $302.00 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $676.08 | Professional | None | $239.88 | $389.05 | $676.08 |
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 $251.19 Median $263.03 Typical High $398.11 | Professional | None | $251.19 | $263.03 | $398.11 |
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 $199.53 Median $323.59 Typical High $537.03 | Professional | None | $199.53 | $323.59 | $537.03 |
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 $89.13 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $89.13 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $35.48 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $134.90 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.78 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $125.89 | $169.82 | $190.55 |
Where Illinois sits
The same service costs 3.9 times more in Alaska than in Texas. 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
$324
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.