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 $125.89 Median $229.09 Typical High $4,168.69 | Facility | None | $125.89 | $229.09 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $288.40 | Professional | None | $97.72 | $154.88 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $223.87 | Professional | None | $134.90 | $147.91 | $223.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $1,071.52 | Facility | None | $154.88 | $251.19 | $1,071.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $269.15 | Professional | None | $112.20 | $169.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $204.17 Typical High $512.86 | Facility | None | $144.54 | $204.17 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $275.42 | Professional | None | $114.82 | $169.82 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $363.08 | Professional | None | $125.89 | $208.93 | $363.08 |
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 $123.03 Median $125.89 Typical High $208.93 | Professional | None | $123.03 | $125.89 | $208.93 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $331.13 | Professional | None | $109.65 | $199.53 | $331.13 |
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 $48.98 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $48.98 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $19.50 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $91.20 Typical High $117.49 | Professional | 54 · Surgery only | $72.44 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $14.45 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.77 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $85.11 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $67.61 | $85.11 | $109.65 |
Where Illinois sits
The same service costs 3.2 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· 27th of 51
$182
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.