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 $74.13 Median $181.97 Typical High $4,677.35 | Facility | None | $74.13 | $181.97 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $169.82 | Professional | None | $60.26 | $97.72 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $154.88 | Professional | None | $87.10 | $114.82 | $154.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $1,202.26 | Facility | None | $257.04 | $309.03 | $1,202.26 |
BCBS Illinois Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $186.21 | Professional | None | $74.13 | $117.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $181.97 | Professional | None | $66.07 | $102.33 | $181.97 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $251.19 | Professional | None | $77.62 | $144.54 | $251.19 |
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 $83.18 Median $83.18 Typical High $147.91 | Professional | None | $83.18 | $83.18 | $147.91 |
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 $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $194.98 | Professional | None | $66.07 | $112.20 | $194.98 |
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 $28.18 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $28.18 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $11.22 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $66.07 Typical High $77.62 | Professional | 54 · Surgery only | $41.69 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.49 Typical High $15.49 | Professional | 55 · Aftercare only | $8.32 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.62 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $61.66 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $38.90 | $61.66 | $72.44 |
Where Illinois sits
The same service costs 3.9 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· 29th of 51
$110
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.