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 $281.84 Median $776.25 Typical High $5,623.41 | Facility | None | $281.84 | $776.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $630.96 | Professional | None | $234.42 | $380.19 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $724.44 | Professional | None | $302.00 | $398.11 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $338.84 Median $512.86 Typical High $2,754.23 | Facility | None | $338.84 | $512.86 | $2,754.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $707.95 | Professional | None | $263.03 | $457.09 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $776.25 | Facility | None | $316.23 | $446.68 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $707.95 | Professional | None | $269.15 | $398.11 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $977.24 | Professional | None | $309.03 | $537.03 | $977.24 |
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 $309.03 Median $323.59 Typical High $562.34 | Professional | None | $309.03 | $323.59 | $562.34 |
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 $281.84 Median $446.68 Typical High $758.58 | Professional | None | $281.84 | $446.68 | $758.58 |
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 $109.65 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $239.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $154.88 | $239.88 | $275.42 |
Where Illinois sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$417
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.