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 $288.40 Median $1,148.15 Typical High $5,623.41 | Facility | None | $288.40 | $1,148.15 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $630.96 | Professional | None | $257.04 | $363.08 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
BCBS Illinois Setting Facility Modifier None Typical Low $616.60 Median $933.25 Typical High $3,019.95 | Facility | None | $616.60 | $933.25 | $3,019.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $724.44 | Professional | None | $288.40 | $457.09 | $724.44 |
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 $295.12 Median $436.52 Typical High $707.95 | Professional | None | $295.12 | $436.52 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $977.24 | Professional | None | $323.59 | $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 $331.13 Median $346.74 Typical High $562.34 | Professional | None | $331.13 | $346.74 | $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 $1,995.26 | Facility | None | $141.25 | $501.19 | $1,995.26 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $776.25 | Professional | None | $302.00 | $457.09 | $776.25 |
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 $117.49 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $117.49 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $35.48 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $245.47 | $275.42 |
Where Illinois sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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· 25th of 51
$437
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.