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 $213.80 Median $524.81 Typical High $4,677.35 | Facility | None | $213.80 | $524.81 | $4,677.35 |
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 $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $2,137.96 | Facility | None | $316.23 | $501.19 | $2,137.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $537.03 | Professional | None | $213.80 | $338.84 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $501.19 | Facility | None | $213.80 | $389.05 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $512.86 | Professional | None | $194.98 | $295.12 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $645.65 | Professional | None | $229.09 | $398.11 | $645.65 |
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 $239.88 Median $251.19 Typical High $416.87 | Professional | None | $239.88 | $251.19 | $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 $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 $194.98 Median $323.59 Typical High $549.54 | Professional | None | $194.98 | $323.59 | $549.54 |
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 $85.11 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $33.88 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $125.89 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.02 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $117.49 | $177.83 | $204.17 |
Where Illinois sits
The same service costs 3.7 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· 21st of 51
$316
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.