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 $269.15 Median $812.83 Typical High $5,623.41 | Facility | None | $269.15 | $812.83 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $602.56 | Professional | None | $229.09 | $346.74 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $549.54 | Professional | None | $275.42 | $281.84 | $549.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $616.60 Median $933.25 Typical High $2,691.53 | Facility | None | $616.60 | $933.25 | $2,691.53 |
BCBS Illinois Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $660.69 | Professional | None | $257.04 | $407.38 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,096.48 | Facility | None | $562.34 | $758.58 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $645.65 | Professional | None | $263.03 | $363.08 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $912.01 | Professional | None | $288.40 | $501.19 | $912.01 |
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 $295.12 Median $302.00 Typical High $524.81 | Professional | None | $295.12 | $302.00 | $524.81 |
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 $1,995.26 | Facility | None | $141.25 | $501.19 | $1,995.26 |
United Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $707.95 | Professional | None | $263.03 | $416.87 | $707.95 |
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 $104.71 Median $162.18 Typical High $181.97 | Professional | 52 · Reduced service | $104.71 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $64.57 Typical High $72.44 | Professional | 53 · Discontinued | $42.66 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $239.88 Typical High $275.42 | Professional | 54 · Surgery only | $158.49 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $32.36 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.38 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $223.87 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $147.91 | $223.87 | $257.04 |
Where Illinois sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 22nd of 51
$407
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.