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 $602.56 Median $1,862.09 Typical High $5,623.41 | Facility | None | $602.56 | $1,862.09 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,174.90 | Professional | None | $537.03 | $707.95 | $1,174.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $6,606.93 | Facility | None | $1,698.24 | $2,570.40 | $6,606.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,348.96 | Professional | None | $660.69 | $933.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,995.26 Typical High $2,570.40 | Facility | None | $630.96 | $1,995.26 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,348.96 | Professional | None | $602.56 | $851.14 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,778.28 | Professional | None | $676.08 | $1,047.13 | $1,778.28 |
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 $724.44 Median $758.58 Typical High $1,047.13 | Professional | None | $724.44 | $758.58 | $1,047.13 |
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 $588.84 Median $870.96 Typical High $1,412.54 | Professional | None | $588.84 | $870.96 | $1,412.54 |
7 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 $257.04 Median $316.23 Typical High $354.81 | Professional | 52 · Reduced service | $257.04 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $104.71 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $389.05 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $77.62 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $52.48 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $363.08 | $446.68 | $501.19 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 51 · Multiple procedures | $645.65 | $645.65 | $645.65 |
Where Illinois sits
The same service costs 4.2 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· 18th of 51
$912
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.