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 $134.90 Median $758.58 Typical High $5,128.61 | Facility | None | $134.90 | $758.58 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $389.05 | Professional | None | $134.90 | $218.78 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $446.68 | Professional | None | $208.93 | $208.93 | $446.68 |
BCBS Illinois Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,584.89 | Facility | None | $281.84 | $457.09 | $1,584.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $446.68 | Professional | None | $158.49 | $281.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $346.74 Typical High $446.68 | Facility | None | $194.98 | $346.74 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $426.58 | Professional | None | $147.91 | $229.09 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $602.56 | Professional | None | $169.82 | $331.13 | $602.56 |
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 $173.78 Median $181.97 Typical High $346.74 | Professional | None | $173.78 | $181.97 | $346.74 |
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 $151.36 Median $257.04 Typical High $446.68 | Professional | None | $151.36 | $257.04 | $446.68 |
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 $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $61.66 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $25.12 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $93.33 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.30 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $87.10 | $141.25 | $169.82 |
Where Illinois sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 26th of 51
$251
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.