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 $758.58 Median $1,949.84 Typical High $6,025.60 | Facility | None | $758.58 | $1,949.84 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,513.56 | Professional | None | $741.31 | $912.01 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $8,912.51 | Facility | None | $1,698.24 | $2,630.27 | $8,912.51 |
BCBS Illinois Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,737.80 | Professional | None | $851.14 | $1,202.26 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $2,570.40 | Facility | None | $741.31 | $2,041.74 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,778.28 | Professional | None | $870.96 | $1,122.02 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,344.23 | Professional | None | $891.25 | $1,380.38 | $2,344.23 |
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 $977.24 Median $1,023.29 Typical High $1,348.96 | Professional | None | $977.24 | $1,023.29 | $1,348.96 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,819.70 | Professional | None | $794.33 | $1,174.90 | $1,819.70 |
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 $346.74 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $645.65 |
Where Illinois sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 16th of 51
$1,175
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.